ACQ Vol 12 No 3 2010

be important in creating a communicatively accessible healthcare setting. Improving the communicative accessibility of healthcare services may be a particularly effective way for speech pathologists to support people with communication disabilities. Any enhancements to the physical environment of the healthcare setting, any improvements in the skills and knowledge of healthcare providers, or any changes to healthcare policies and procedures not only benefit people with communication disabilities receiving healthcare now, but also will benefit people with communication disabilities needing healthcare from that service in the future (O’Halloran, Hickson, & Worrall, 2008). A review of the literature on the range of environmental factors that create barriers to and/or facilitate communication for people with communication disabilities in the hospital setting identified many different environmental factors that influence the ability of patients with communication disabilities to communicate effectively with healthcare providers in hospital (O’Halloran et al., 2008). For example, some environmental factors related to: 1. products and technology, such as the availability of assistive listening devices and communicatively accessible formats, 2. support and relationships, including the knowledge, skills and attitudes of healthcare providers, and 3. services, systems, and policies, such as hospital policies on hearing accessibility. Although further research is needed to better understand the range of environmental factors that influence the ability of people with different types of communication disabilities to communicate, research is also needed to understand how healthcare settings can be made more communicatively accessible so that people with communication disabilities and their healthcare providers can communicate more successfully. This issue of the ACQ provides an opportunity to share the innovative clinical and research efforts of some of the Australian speech pathologists and audiologists who are working towards the development of communicatively accessible healthcare environments. These articles suggest that the creation of communicatively accessible healthcare environment requires a high level of commitment, support from executive administration, and effort over a long period of time. These articles also indicate that creating and maintaining communicatively accessible environments calls for a long-term commitment so that the communication needs of people with communication disabilities are considered on an ongoing basis as healthcare settings and services continue to evolve. Finally, although the challenges and complexities involved in creating communicatively accessible healthcare environments may appear daunting, the articles contained in this issue provide us with a glimpse Balandin, S., Hemsley, B., Sigafoos, J., & Green, V. (2007). Communicating with nurses: The experiences of 10 adults with cerebral palsy and complex communication needs. Applied Nursing Research , 20 , 56–62. Bartlett, G., Blais, R., Tamblyn, R., Clermont, R., & MacGibbon, B. (2008). Impact of patient communication problems on the risk of preventable adverse events in acute care settings. Canadian Medical Association Journal , 178 (12), 1555–1562. of what is possible. References

Hines, J. (2000). Communication problems of hearing- impaired patients. Nursing Standard , 14 (19), 33–37. Hoffman, J., Yorkston, K., Shumway-Cook, A., Ciol, M., Dudgeon, B., & Chan, L. (2005). Effect of communication disability on satisfaction with healthcare: A survey of medicare beneficiaries. American Journal of Speech- Language Pathology , 14 , 221–228. Iacono, T., & Davis, R. (2003). The experience of people with developmental disability in emergency departments and hospital wards. Research in Developmental Disabilities , 24 , 247–264. Iezzoni, L., O’Day, B., Killeen, M., & Harker, H. (2004). Communicating about healthcare: Observations from persons who are deaf or hard of hearing. Annals of Internal Medicine , 140 (5), 356–362. Moelker, A., Maas, R., & Pattynama, P. (2004). Verbal communication in MR environments: Effect of MR system acoustic noise on speech understanding. Radiology, July , 107–113. Nzegwu, F. (2004). The experience of visually impaired users of the NHS. Retrieved from http://www.guidedogs.org. uk/index.php?id=1474 O’Day, B., Killeen, M., & Iezzoni, L. (2004). Improving healthcare experiences of persons who are blind or have low vision: Suggestions from focus groups. American Journal of Medical Quality , 19 (5), 193–200. O’Halloran, R., Hickson, L., & Worrall, L. (2008). Environmental factors that influence communication between people with communication disability and their healthcare providers in hospital: A review of the literature within the International Classification of Functioning, Disability and Health (ICF) framework. International Journal of Language and Communication Disorders , 43 (6), 601–632. Parr, S., Byng, S., Gilpin, S., & Ireland, C. (1997). Talking about aphasia: Living with loss of language after stroke . Buckingham: Open University Press. Roter, D., & Hall, J. (2006). Doctors talking with patients/ Patients talking with doctors: Improving communication in medical visits (2nd ed.). Westport, CT: Praeger. Schou, L., & Egerod, I. (2008). A qualitative study into the lived experience of post-CABG patients during mechanical ventilator weaning. Intensive and Critical Care Nursing , 24 , 171–179. World Health Organization (2001). International classification of functioning, disability and health . Geneva: Author. Wright, K., Sparks, L., & O’Hair, D. (2008). Health communication in the 21st century . Oxford: Blackwell Publishing. Robyn O’Halloran completed her PhD at the University of Queensland in 2009. She works part-time as a lecturer in the School of Human Communication Sciences at La Trobe University, Victoria, and part-time as a postdoctoral fellow in the Centre for Clinical Research Excellence in Aphasia Rehabilitation.

Correspondence to: Robyn O’Halloran, PhD Human Communication Sciences La Trobe University, Bundoora 3086 Victoria phone: +613 9479 1818 email: R.O’Halloran@latrobe.edu.au

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ACQ Volume 12, Number 3 2010

www.speechpathologyaustralia.org.au