Runtime: 1.38 min.
Focus: Colin Phillips on communication access within healthcare services
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Runtime: 4:38 mins
Focus: Steve Wells on communication barriers in a healthcare setting.
The following information is intended to provide a starting point to improve access to services for people with speech and language disabilities, not caused by hearing loss. It is by no means a full comprehensive list of barriers or accommodations. It presents some of the unique challenges that people with SLDs may experience within this situation.
Contact us for more information on making your services accessible.
Sample Communication Access Barriers to hospital in-patient services
Many of us who have pre-existing Speech Language Disability (SLD), experience the same barriers to hospital services as people who have mobility, sensory and other disabilities. In addition, we may experience unique communication barriers due to our speech and language disability that impact on the quality of services we receive and have serious consequences.
Barriers may include:
- Healthcare professionals not knowing how we communicate, or being able to understand our messages
- Healthcare professionals not giving us information in ways we can understand
- Hospitals not having appropriate communication tools and methods available for us to use in emergencies
- Hospitals not having trained communication assistants to support us to effectively communicate throughout our hospital stay
- Patient Intake and Admissions Services not being able to get accurate information from us
- Healthcare professionals not knowing how to obtain our informed consent to treatment and advance care directives
- Hospital not knowing their obligations to provide communication supports for people with SLDs as required by the law (Eldridge v. British Columbia (Attorney General)  2 S.C.R. 624)
- Hospitals not providing access the nurse’s call bell to get attention in an emergency
Suggestions for Healthcare Providers in Hospitals
In addition to generic communication access accommodations, healthcare services should:
- Ensure that we understand our rights, including our right to be given supports and communication tools that may be required for effective communication during a hospital stay
- Obtain reliable admission information from us or from a person that we have delegated to provide this information on our behalf
- Include relevant information about our preferred communication methods, and our communication access needs in terms of understanding spoken language as well as having our messages accurately interpreted by my healthcare team
- Obtain information about procedures to obtain our informed consent to treatment, advance care directives and other health law documents
- Provide extra time with to our health team to accommodate our reduced rate of communication
- If necessary, provide communication methods and trained assistants to ensure we understand and can accurately communicate about consent to treatment, capacity assessments, appointment of substitute or supportive decision makers, advance care and end-of life directives
- Identify the need for a Speech-Language Pathology referral to assist us if we require additional communication methods and supports
- Anticipate, monitor, and adjust our communication needs during the course of treatment due to changes in our stamina, alertness, physical positioning etc.
- Obtain information on whether we need assistance with reading, understanding and completing healthcare written forms and documents
- Ensure we can access nurse call bells and alert systems
- If services involve telephone use, give us other ways to contact you such as text, email and SMS
- Make sure your signs are easy to understand and are at a level that can be seen by those of us who use wheelchairs
Resources for Healthcare Providers
- CAN E-learning modules
- Patient provider communication
- Commercial healthcare vocabulary displays
- Blackstone, Beukleman and Yorkston (2015) Patient-Provider Communication: Roles for Speech-Language Pathologists and other Health Care Professionals. www.pluralpublishing.com
Suggestions for People with SLDs
- Carry our communication access card with us and show it to receptionist and / or service provider (see resource below). If appropriate ask that they make a copy and keep it in our file
- If we have time to plan our hospital visit, we may want to prepare vocabulary in our device or on a communication display. We may want to contact our speech and language pathologist or AAC clinician to assist us with this.
- Check out some commercial vocabulary displays in the resources listed below.
- If we think we might require a communication assistant, give some thought as to who we want to be with us and when. If we don’t have someone to assist us, we can ask our healthcare professionals to engage someone to provide this support.
Resources for People with SLDs