Assessing communication capacity in the acute hospital setting

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Assessing communication capacity in the acute
hospital setting

• Presenter Robyn OHalloran
• Authors Robyn OHalloran, Linda Worrall, Louise
  Hickson

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Background

• The ICIDH-2 (and ICF) frameworks prompted us to
  ask What would an assessment of a persons
  communication Activities and Participation in the
  acute hospital setting look like?
• What are the communication activities that occur
  in hospital?
• How would you assess a persons ability to
  communicate in these activities?
• Would this be of any benefit to people admitted
  into hospital?

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1. What are hospital communication activities?

• First, we interviewed groups of patients and
  hospital staff using the nominal group technique.
• Second, we directly observed the communication
  activities that occurred between patients and
  staff.
• Then we combined these two sources of
  information. This gave us a list of 31 hospital
  communication activities.

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Some of the 31 hospital communication activities

• Following instructions
• Asking questions about care
• Understanding information about the current
  medical condition
• Telling about pain
• Giving greetings and farewells
• Engaging in social conversation
• Reading for pleasure
• Expressing appreciation

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2. How would you assess a persons communication
ability?

• 2a. Which communication activities should we
  assess?
• We wanted a short practical assessment, therefore
  we only included those activities that
• could be assessed reliably,
• were important to patients,
• were important to healthcare staff, and
• were typical hospital activities.

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The IFCI activities

• Gaining the patients attention
• Telling what has happened to bring them into
  hospital
• Understanding the medical diagnosis or reason for
  admission and the implications of the current
  medical condition
• Following instructions
• Expressing feelings
• Telling you preadmission medical history and
  current medical concerns

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• Understanding descriptions about what is
  happening
• Asking questions about their care
• Telling you about pain or discomfort
• Asking for something
• Telling you about what they do/dont like
• Calling for a nurse

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The IFCI

• 2b How should we assess a persons ability to
  communicate in these activities when they are in
  hospital?
• Speech pathologist conducts a semi structured
  interview at the persons bedside.
• The speech pathologist seeks to determine how
  well the person can communicate in these hospital
  situations and what strategies, if any, might
  facilitate more successful communication with the
  person.
• The interaction is scored as successful,
  partially successful or unsuccessful.

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3. Is this of any benefit to people?

• Effective communication between people admitted
  into hospital and their healthcare providers
• results in immediate health benefits for people,
• improves the accuracy of medical diagnosis,
• ensures people get the most appropriate care in
  hospital,
• improves the effectiveness of health education,
• improves a persons adherence to any healthcare
  recommendations, and
• improves a persons satisfaction with the care
  they receive, and reduces complaints and the risk
  of medicolegal action.

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Whats next?

• Is there a relationship between a persons
  communication Impairment, his/her communication
  environment and/or personal characteristics and
  successful communication in hospital?
• Is there a hospital communicative environment?

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IFCI references

• McCooey-OHalloran, R., Worrall, L. and Hickson,
  L. (2004). Evaluating the role of speech-language
  pathology with patients with communication
  disability in the acute hospital setting using
  the ICF. Journal of medical speech-language
  pathology, 12, 49-58.
• OHalloran, R., Worrall, L., Toffolo, D., Code,
  C., and Hickson, L. (2004). The inpatient
  functional communication interview. Speechmark
  Oxon, U.K.
• OHalloran, R., Worrall, L. and Hickson, L. (in
  press). Development of a measure of communication
  activity for the acute hospital setting Part I.
  Rationale and preliminary findings. Journal of
  medical speech-language pathology.
• OHalloran, R., Worrall, L., Hickson, L. And
  Code, C. (in press). Development of a measure of
  communication activity for the acute hospital
  setting Part II. Item analysis, selection and
  reliability. Journal of medical speech-language
  pathology.
• Contact details
• Robyn OHalloran Email s374859_at_student.uq.edu.au