Tailored communication strategies for hospital staff

2.7 Speech pathologists should provide hospital staff with individualised communication strategies that are tailored to enhance both care-related and social and emotional communication with each patient with aphasia.

Reference: Bartlett et al., 2008: Retrospective chart review; Bright & Reeves, 2022: Qualitative meta-synthesis; Carragher et al., 2021: Qualitative study; Carragher et al., 2024: Qualitative study; Clancy et al., 2020: Qualitative study; D’Souza et al., 2021a: Qualitative study; D’Souza et al., 2021d: Qualitative study; Heard et al., 2022: Qualitative study; Hemsley et al., 2013: Qualitative study; O’Halloran et al., 2012: Qualitative meta-synthesis; Shand et al., 2024: mixed methods study; Sullivan et al., 2023: Qualitative study

NHMRC level of Evidence: Qual

Rationale: People with communication difficulty are three times more likely to experience preventable adverse events in hospital (Bartlett et al., 2008). Adverse events for people with aphasia have been reported to be associated with specific difficulties communicating their needs to staff (Hemsley et al., 2013; Sullivan et al., 2023). However, effective and positive healthcare communication can improve patient experience (Bright & Reeves, 2022; Clancy et al., 2018; D’Souza et al., 2021a; Heard et al., 2022) for people with communication disability in hospital settings. Individually tailored communication strategies can help facilitate healthcare communication (Carragher et al., 2021; Carragher et al., 2024; Clancy et al., 2018; D’Souza et al., 2021a; Heard et al., 2022; Shand et al., 2024).

Each patient should be assessed by a speech pathologist to identify the patient’s communication needs and the tailored strategies that are effective in meeting these needs (Shand et al., 2024). Speech pathologists should recommend individually tailored communication support strategies to health staff. The successful implementation of communication strategies requires that recommendations are clearly communicated to health staff (Heard et al., 2022) who have knowledge of aphasia and positive attitudes towards communicating with people with a communication disability (O'Halloran et al., 2012).

By providing strategies that target both transaction (i.e., the exchange of information) and interaction (i.e., the relational element of communication), therapeutic relationships can be fostered (Bright & Reeves, 2022). This may in turn result in improved engagement in the rehabilitative process, a sense of safety, and promotion of wellbeing and adjustment to stroke during early recovery for people with aphasia (Bright & Reeves, 2022; Clancy et al., 2020).

References:

1. Bartlett, G., Blais, R., Tamblyn, R., Clermont, R., & MacGibbon, B. (2008). Impact of patient communication problems on the risk of preventable ad- verse events in acute care settings. Canadian Medical Association Journal, 178, 1555-1562. DOI: 10.1503/cmaj.070690
2. Bright, F.A.S. & Reeves, B. (2022). Creating therapeutic relationships through communication: A qualitative metasynthesis from the perspectives of people with communication impairment after stroke. Disability and Rehabilitation, 44(12), 2670-2682. DOI: 10.1080/09638288.2020.1849419
3. Carragher, M., Steel, G., O’Halloran, R., Torabi, T., Johnson, H., Taylor, N.F. & Rose, M. (2021) Aphasia disrupts usual care: The stroke team’s perceptions of delivering healthcare to patients with aphasia. Disability and Rehabilitation, 43(21), 3003-3014. DOI: 10.1080/09638288.2020.1722264
4. Carragher, M., Steel, G., O'Halloran, R., Lamborn, E., Torabi, T., Johnson, H., Taylor, N. F., & Rose, M. L. (2024). Aphasia disrupts usual care: "I'm not mad, I'm not deaf" - the experiences of individuals with aphasia and family members in hospital. Disability and rehabilitation, 1–12. Advance online publication. https://doi.org/10.1080/09638288.2024.2324115
5. Clancy, L., Povey, R., & Rodham, K. (2020). "Living in a foreign country": experiences of staff-patient communication in inpatient stroke settings for people with post-stroke aphasia and those supporting them. Disability and Rehabilitation, 42(3), 324–334. https://doi.org/10.1080/09638288.2018.1497716
6. D’Souza, S., Hersh, D., Godecke, E., Ciccone, N., Janssen, H., & Armstrong, E. (2021a). Patients’ Experiences of a Communication Enhanced Environment model in an acute/slow stream rehabilitation ward and a rehabilitation ward following stroke: A Qualitative Description Approach. Disability and Rehabilitation, 44(21), 6304–6313 https://doi.org/10.1080/09638288.2021.1965226
7. D’Souza, S., Godecke, E., Ciccone, N., Hersh, D., Janssen, H. Armstrong, E., & (2021d). Hospital staff, volunteers’, and patients’ perceptions of barriers and facilitators to communication following stroke in an acute and private perceptions of a Communication Enhanced Environment model in an acute and private rehabilitation hospital ward: A qualitative description study. BMJ Open, 11(5), doi.org/10.1136/bmjopen-2020-043897.
8. Heard, R., Anderson, H., & Horsted, C. (2022). Exploring the communication experiences of stroke nurses and patients with aphasia in an acute stroke unit. Speech, Language and Hearing, 25(2), 177-191. DOI: 10.1080/2050571X.2020.1833284
9. Hemsley, B., Werninck, M., & Worrall, L. (2013). “That really shouldn’t have happened”: People with aphasia and their spouses narrate adverse events in hospital. Aphasiology, 27(6), 706-722. DOI: 10.1080/02687038.2012.748181
10. O’Halloran, R., Grohn, B., & Worrall, L., (2012). Environmental factors that influence communication for patients with a communication disability in acute hospital stroke units: A qualitative metasynthesis. Archives of Physical and Medical Rehabilitation, 93(1), 77-85. DOI: 10.1016/j.apmr.2011.06.039
11. Shand, R., Foster, A., Baker, C., & O'Halloran, R. (2024). Identifying communication difficulty and context-specific communication supports for patient-provider communication in a sub-acute setting: A prospective mixed methods study. International Journal of Speech Language Pathology, 1–20. https://doi.org/10.1080/17549507.2023.2289350
12.  Sullivan, R., Hemsley, B., Harding, K., & Skinner, I. (2023). 'Patient Unable to Express Why He Was on the Floor, He Has Aphasia.' A Content Thematic Analysis of Medical Records and Incident Reports on the Falls of Hospital Patients with Communication Disability Following Stroke. International Journal of Language & Communication Disorders, 58(6), 2033–2048. https://doi.org/10.1111/1460-6984.12916