How can I help other team members understand how speech, language, and cognition contribute to communication difficulties in the inpatient setting?

Question

Answer

Here are a couple of approaches.  One might work better than the other in your situation but don’t be afraid to use both or combine them to devise a third approach that works better for you!

1. The first approach is the “in-service” method.  Offer to provide a short training session for staff (many organizations offer these in the form of “brown bags,” which occur during a lunch break).  Set the scene by describing a specific situation, such as a patient who comes in for an appointment and has trouble following directions.  Describe options for communication, such as writing down keywords or a couple of different options (Wood, Lasker, Siegel-Causey, Beukelman, & Ball, 1998) on a notepad or small whiteboard. Then, demonstrate a specific strategy, perhaps with someone in the audience.  You want to demonstrate how the strategy is worked into their typical communication exchange with the patient.

Cover in-service topics such as:

• How to help patients communicate a variety of messages at crucial times.
• Changes in status, context, topics, or partners 
• Frustrations - need for persistence and patience.
• Need to keep teaching new partners over time - as staff changes.
• Something quick, efficient, and nonfatiguing, that won’t break down is needed.
• There are challenges associated with patient access, awareness, and timing of interventions.

2. The second approach involves building on what they’re already doing successfully.  For this you could start by asking the provider to give an example of when they get really frustrated with communication.  Then, ask them what they’ve tried and how well it worked.  Often, the best solutions are those that people develop in the moment.  You might need to encourage them to keep doing it.  You might also see a way to add to what they’re doing to make it more effective.

Also, if you can create communication opportunities that result in success for your co-workers and patients, there may be more buy-in regarding the resources and interventions you offer.  Successful communication is always the best reward, so if you can arrange for them to try out a strategy right away and be there when it happens to offer guidance, you can set them up for success, and that will engender more motivation to keep doing it.

If you want communication partners to use something, like a dry-erase board or notebook, try to have those tools available for them during the lesson and allow them to take it with them to use.  That will avoid the excuse that materials aren’t available when needed.

This Ask the Expert is an excerpt from the course, 20Q: Communication Strategies for Inpatients Who Can’t Talk, authored by Elizabeth K. Hanson, PhD, CCC-SLP, Joanne Lasker, PhD, CCC-SLP and Laura Ball, PhD, CCC-SLP.