Hospital communication boards

Also called Ward communication boards, Patient communication boards, ICU communication boards, Bedside communication charts

Boards kept on wards so a person who cannot speak can say pain, cold, toilet, when, and who, and why every ward should have one on every shift.

What it is

A hospital communication board is a laminated sheet, or a few pages, kept on the ward so that a patient who cannot speak can point to what they need. Pain, and where. Cold, hot, thirsty, sick, toilet. Yes, no, wait, stop. The alphabet. A body outline. A pain scale. Questions a patient asks: when, who are you, what is happening, can I have my glasses.

The people who need it are more numerous than most wards assume. A person with a tube in their throat in intensive care. Someone the morning after a stroke. A person with dementia in an unfamiliar bay. Someone with a learning disability whose own device is at home. A Deaf person waiting for an interpreter. Someone whose English is new. Every one of them can point.

The Accessible Information Standard requires NHS services in England to meet a patient's communication needs, and a board on the ward is the cheapest possible way to start meeting that duty at three in the morning.

Who it can help

Any patient who cannot speak or cannot be understood for any reason, for any length of time, and the staff looking after them, who otherwise guess. In intensive care the group is largest: most ventilated patients cannot speak while the tube is in, and studies of their experience repeatedly put not being able to communicate near the top of what frightened them.

It helps families, who often become the interpreter and who can use the board with the person when staff are busy. And it helps the person who has their own AAC device by giving them something when the device is charging, out of reach or not allowed in the scanner.

It is a stopgap, not a substitute for the person's own system or for a speech and language therapy assessment, and a patient who will be unable to speak for weeks needs a referral, not a laminated sheet.

How it works

The patient points to a cell with a finger, a fist, a gaze, or a nod as the partner runs a finger along the rows. That last method, partner-assisted scanning, is what makes the board work for someone too weak to lift a hand: the nurse points to each row, the patient signals at the right one, the nurse points along it, and the patient signals at the word.

A good board has the essentials in large cells, a body map for pain, a scale, yes and no in the corners where they can be reached without searching, and an alphabet for spelling anything else. Symbols beside words let a person who cannot read still use it. Several NHS trusts and charities publish free ones, and the ACE Centre and Communication Matters can direct you to them.

The board lives at the bedside, is mentioned at handover, and is wiped between patients. That last part is why it is laminated.

Getting started

If you are a relative, ask the nurse in charge today whether the ward has a communication board, and if it does not, print one and bring it in. Use it with the person yourself: point to yes and no, point along the rows, and write down the words the person uses most so staff can find them fast. Put the person's hospital passport or communication passport beside it.

If you are a nurse or a therapist, get a board onto every bay, put a line in the handover template, and show the healthcare assistants how partner-assisted scanning works in five minutes. Ask the speech and language therapy team for the trust's approved version.

If the person has a phone or tablet, the free Talk board runs in the browser with no account, works offline once loaded, and speaks the words aloud, which helps across a noisy ward.

Where to get help

Communication Matters for AAC in hospital and for free boards. The ACE Centre publishes free printable communication resources. The Royal College of Speech and Language Therapists sets professional standards for communication in acute care. NHS England owns the Accessible Information Standard. For the ward itself, ask for the speech and language therapy team, who exist in every acute trust.