Developing a Culture of Successful Communication in Acute Care Settings: Part II. Solving Institutional Issues.

Purpose: Establishing services for hospitalized patients with complex communication needs (CCNs) requires identifying and addressing both patient-based and institutional barriers. Although the previous paper (Marshall & Hurtig, 2019) focused on patient-based barriers, this paper addresses overcoming institutional barriers.

Method: We present a series of cases to illustrate the institutional challenges in meeting the CCNs of patients in an acute care setting.

Developing a Culture of Successful Communication in Acute Care Settings: Part I. Solving Patient-Specific Issues.

Purpose: Establishing services for hospitalized patients with complex communication needs requires identifying and addressing both patient-based and institutional barriers. In this 1st article, we focus on overcoming patient-based barriers. The companion paper (Marshall & Hurtig, 2019) addresses overcoming institutional barriers.

Forum on Augmentative and Alternative Communication in Acute Care.

This forum provides some insights into the process of initiating a clinical service to enhance patient- provider communication. It also provides a report of a large-scale clinical trial that introduced augmentative and alternative communication (AAC) tools in an acute-care setting.

Improving Patient Safety and Patient-Provider Communication.

Purpose: Many hospitalized patients experience barriers to effective patient-provider communication that can negatively impact their care. These barriers include difficulty physically accessing the nurse call system, communicating about pain and other needs, or both. For many patients, these barriers are a result of their admitting condition and not of an underlying chronic disability.

The role of maternal psychosocial perceptions in parent-training programs: a preliminary randomized controlled trial.

Parent-child interaction is critical for early language and literacy development. Parent training programs have proliferated to support early interactions. However, many environmental and psychosocial factors can impact the quality of parent-child language and literacy interactions as well as training program outcomes.

The cost of not addressing the communication barriers faced by hospitalized patients.

Preventable adverse events (AEs) lead to poorer patient outcomes, added patient suffering and dissatisfaction, longer hospital stays, and billions in additional annual healthcare spending. Patients facing barriers to communication are three times more likely to experience a preventable adverse event than patients who faced no communication barriers. National data on hospital admissions, incidence and cost of preventable AEs, and the odds ratio regarding the risk of preventable AEs in people facing communication barriers were used to estimate potential benefits of improving patient communication.

Technology-enhanced shared reading with deaf and hard-of-hearing children: the role of a fluent signing narrator.

Early shared reading experiences have been shown to benefit normally hearing children. It has been hypothesized that hearing parents of deaf or hard-of-hearing children may be uncomfortable or may lack adequate skills to engage in shared reading activities. A factor that may contribute to the widely cited reading difficulties seen in the majority of deaf children is a lack of early linguistic and literacy exposure that come from early shared reading experiences with an adult who is competent in the language of the child.

Digital noise reduction: outcomes from laboratory and field studies.

The purpose of this study was to determine the impact of a digital noise reduction (DNR) scheme implemented in a current commercial hearing aid. In a double-blinded design, three conditions of onset time (4, 8, 16 seconds) were randomly assigned to the 25 subjects, plus one condition wherein the noise-reduction feature was disengaged. Subsequently, a fifth trial/condition, wherein the subject had access to three memories in which the different onsets were programmed, was carried out.

Imitative production of rising speech intonation in pediatric cochlear implant recipients.

Purpose: This study investigated the acoustic characteristics of pediatric cochlear implant (CI) recipients' imitative production of rising speech intonation, in relation to the perceptual judgments by listeners with normal hearing (NH).

Method: Recordings of a yes-no interrogative utterance imitated by 24 prelingually deafened children with a CI were extracted from annual evaluation sessions. These utterances were perceptually judged by adult NH listeners in regard with intonation contour type (non-rise, partial-rise, or full-rise) and contour appropriateness (on a 5-point scale).

Augmentative and alternative communication.

With the help of a knowledgeable interdisciplinary team, individuals can find the best AAC system to meet their needs and enrich their quality of life. A new-found ability to communicate often significantly improves a person's overall prognosis and may prevent serious problems in the areas of behavior, learning, reading, and social development. However, because an AAC system is just one component of multimodal communication, it should not inhibit the use of speech by individuals who have some usable or functional speech.

Effects of smoking marijuana on brain perfusion and cognition.

The effects of smoking marijuana on regional cerebral blood flow (rCBF) and cognitive performance were assessed in 12 recreational users in a double-blinded, placebo-controlled study. PET with [(15)Oxygen]-labeled water ([(15)O]H(2)O) was used to measure rCBF before and after smoking of marijuana and placebo cigarettes, as subjects repeatedly performed an auditory attention task. Smoking marijuana resulted in intoxication, as assessed by a behavioral rating scale, but did not significantly alter mean behavioral performance on the attention task.

Effects of frequent marijuana use on memory-related regional cerebral blood flow.

It is uncertain whether frequent marijuana use adversely affects human brain function. Using positron emission tomography (PET), memory-related regional cerebral blood flow was compared in frequent marijuana users and nonusing control subjects after 26+ h of monitored abstention. Memory-related blood flow in marijuana users, relative to control subjects, showed decreases in prefrontal cortex, increases in memory-relevant regions of cerebellum, and altered lateralization in hippocampus.