Helping health workers and patients communicate

Helping health workers and patients communicate

During the pandemic we have all learned how Covid-19 can leave people struggling to breathe, leading to panic, stress and anxiety. As the symptoms intensify, a patient has more and more difficulty in speaking, and the loss of this basic human need can add to the sense of panic for many. For those who already have communication difficulties, experts worldwide have expressed concerns about a lack of support during the pandemic.

Woman with ipad and stethoscope
"The use of symbols supports a universal form of communication." - E.A. Draffan, Fellow

For example, Theresa Rodgers, President of the American Speech and Hearing Association, has said: "People deserve to have their basic needs met, such as to communicate that they are in pain or request that a loved one is called, but patients may be more likely to have a serious adverse medical event if they cannot communicate with their healthcare providers."

Finding a means to maintain communication and human interaction is at the heart of the work of Global Symbols, the online platform that I co-founded. When speech is not possible, we often depend on body language, facial expression and written communication. The latter may be in the form of words or pictures to explain ideas. Communication charts can ease misunderstandings and are often available online, but many do not allow for personalisation. Funds have been raised to provide tablets for individuals to communicate with their families. However, there is little mention of the use of symbols or images to help those who may already have communication disabilities or difficulties with spoken English.

The project I am currently working on offers alternative forms of communication to health professionals and carers, which support easy-to-understand messaging in emergency contexts. To do this, I am developing an app called Boardbuilder that involves the use of charts, symbols and pictographic images, which the patient can select in order to communicate with their carer. At present, the freely available chart builder app provides access to a range of culturally sensitive symbols in English, but is not customisable.

Symbols included in the Boardbuilder app
Examples of symbols E.A. created for the Boardbuilder app Download 'E. A. Draffan_Blog2.png'

We are a diverse society, and our interactions reflect our culture and community. Not all patients will be fluent in English, and images and words that feel familiar will enhance that important bond between communication partners. When a chart can be created in minutes, a health worker can collaborate with the patient to support simple explanations and requests. The patient confirms the selection of symbols, images or words or chooses them directly. Thanks to a grant from the Churchill Fellowhip's Covid-19 Action Fund, I will be able to work with my colleagues to increase the availability of free and open licensed symbol-set vocabularies related to Covid-19. This includes developing a symbol creation tool, which will allow anyone to add and adapt suitable images and expand on the vocabulary as required. For those who have used symbols to communicate before falling ill, Boardbuilder will allow families and carers to export charts to communication software applications on phones and tablets, so the symbol labels are spoken out by the technology. Charts can also be printed out and laminated or work with low-tech devices. 

The need for freely available tools and resources is relevant to a wide range of emergencies. Clarity of communication is essential in ensuring access to appropriate services and support for disabled people or those traumatised by circumstances. The use of symbols supports a universal form of communication, reducing dependency on speech or text in conditions requiring rapid intervention or triage. Personalisation and localisation of these forms of communication are vital as relationships build. Customised symbol charts or instructions clarify complex situations for those with any speech, language, hearing, cognitive or literacy difficulty. By learning from the current crisis, I am hoping to build a sustainable solution for everyone in the future.


The views and opinions expressed by any Fellow are those of the Fellow and not of the Churchill Fellowship or its partners, which have no responsibility or liability for any part of them.


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