- This event has passed.
Facilitators and Barriers of using a Generic Communication Toolkit in a Singapore Acute Hospital
October 28, 2025 @ 11:30 pm – October 29, 2025 @ 12:00 am EDT
Speakers
-
Xuet Ying Tan
ISAAC Singapore Chapter
Abstract
Background:
Communication barriers between healthcare professionals and patients with acquired communication disorders in acute neurology wards represent a significant challenge in healthcare delivery. These patients experience frequent communication barriers (Bartlett et al., 2008; Beukelman et al., 2007; Karliner et al., 2012; Norouzinia et al., 2015; Reed et al., 2020) that negatively impact their physical and psychological health (Handberg & Voss, 2018; Jenstad et al., 2024). Alternative and Augmentative Communication (AAC) ( Finke et al., 2008; Godecke et al., 2013; Santiago et al., 2021), encompassing both high-tech and low-tech options (Fried-Oken et al., 1991), can be a potential solution to address these communication challenges. Despite substantial evidence supporting the benefits of AAC implementation for both patients and healthcare professionals (Light & McNaughton, 2015; ASHA, n.d.; ten Hoorn et al., 2016), its adoption and utilisation within hospital settings remain notably low due to various barriers (Balandin et al., 2007; Heard et al., 2022; Karliner et al., 2012).
Previous research in this field has predominantly concentrated on other patient populations, particularly those in Intensive Care Units (Grossbach et al., 2011; Gumm et al., 2017; Reed et al., 2020; ten Hoorn et al., 2016; Wilkinson et al., 2021;). No studies were conducted in Singapore or Asia, and none specifically looked at healthcare professionals like physiotherapists and occupational therapists, both of whom interact frequently with patients with neurological conditions. It is important to gather perspectives from the frequent communication partners when implementing AAC intervention to maximise effectiveness (Murray & Hopf, 2022).
Aim:
This study sought to investigate the facilitators and barriers affecting healthcare professionals’ likelihood of using a generic communication toolkit “Communikit” in Tan Tock Seng Hospital’s (TTSH) acute neurology wards, addressing the research gap in understanding AAC implementation in Asian healthcare contexts.
Methods:
The study received ethical approval from the National Healthcare Group (NHG) Domain Specific Review Board (DSRB 2024/00250). The study employed a qualitative research design utilising focus groups and individual interviews. Physiotherapists, Occupational Therapists, and nurses (healthcare professionals who frequently interact with patients) with at least 3 months experience working in Tan Tock Seng Hospital Neurology wards were recruited. They were asked about the challenges they face communicating with patients in Neurology wards, the communication approaches they use, and their impressions of the “Communikit”. Audio recordings of the interviews were transcribed. Thematic analysis of the transcripts were carried out with Quirkos using a hybrid approach of inductive and deductive coding.
Results:
Participants included four occupational therapists (OT), three physiotherapists (PT), and one nurse, with varying levels of experience in neurology wards. Most participants had between six months to two years of experience, with two participants (one OT and one nurse) having more than two years of experience.
Qualitative analysis revealed several significant themes regarding facilitators and barriers to “Communikit” use. Key facilitators identified included AAC training for healthcare professionals, consistent availability of the “Communikit” at every patient’s bedside, and customisation of picture communication charts to meet discipline-specific needs. Patient and family initiation of AAC use was also noted as a positive factor in implementation. Primary barriers to implementation included time constraints and healthcare professional perceptions. Many participants expressed that existing communication approaches, primarily verbal communication combined with gestures, were both adequate and less time-consuming than using “Communikit”. Some healthcare professionals perceived “Communikit” as too complex for their patient population in the neurology ward.
Discussion/ Conclusions:
The study findings suggest that successful implementation of the “Communikit” requires a comprehensive, multi-faceted approach. Key recommendations include developing discipline-specific picture communication charts in consultation with respective departments, ensuring simplified “Communikit” availability at each patient’s bedside, providing AAC training for healthcare professionals, developing educational materials for caregivers, and upskilling the healthcare professionals in the utility of AAC tools with ongoing speech and language therapy support. While the study was limited by a low recruitment rate that may have overrepresented minority views, it provided valuable insights for future research directions, including investigation of important communication topics for stakeholders in Singapore, evaluation of AAC training impacts, and assessment of “Communikit” use on patient participation in activities.