¾ÅÓÎÌåÓý

Personal protective equipment (PPE) is one of the most important components of delivering and receiving safe healthcare during the COVID-19 pandemic. Its use, however, brings unique challenges to the art of communication.

PPE, which includes masks and face shields, provides a protective layer to reduce the risk of large respiratory droplets spreading from person to person. In doing so, it distorts speech sounds, eliminates lip reading and hides facial expressions which are important auditory and non-verbal cues for effective communication. For care providers, this can diminish their ability to establish trust and emotionally connect with patients. For patients, it can contribute to feelings of isolation and fear.

“We rely so heavily on a simple smile,â€� says Leah Silber, speech language pathologist (SLP) at Michael ¾ÅÓÎÌåÓý (MGH). “As healthcare workers, we’ve all seen the effect of PPE on communication with our patients.â€�

When Leah and her SLP colleagues heard about healthcare workers using photographs of themselves to compensate for this communication breakdown, they were inspired to launch the PPE Portrait Project at MGH, which aims to improve communication and connection by clinicians affixing a badge with a photograph of their smiling face to their outer protective gear.

“There is uniformity to PPE. The PPE Portrait Project allows patients to connect with us as individuals,� says Leah.

But the project is about more than just a photograph; badges are supplemented with education on how to use verbal and alternative non-verbal communication to establish positive patient rapport. This includes:

1. Using phrases to communicate friendliness: “It’s nice to see you today�
2. Acknowledging communication barriers: “You might have difficulty hearing/recognizing me�
3. Being an active listener: Establishing eye contact & check-in for understanding throughout conversation
4. Using gestures to communicate feeling: Waving hello, patting hand in compassion
5. Writing key words: Using pen and paper for those with significant hearing impairment
6. Building connection: Inquiring how else to be of assistance

The project will begin initially as a pilot with fifteen patient-facing SLPs and pccupational therapists. Over the course of two to three plan-do-study-act (PDSA) cycles, a short survey will be distributed and findings will be used to guide revisions. Team members will also be taught the proper donning and doffing procedure in advance of the trial to ensure a scalable, safe process in line with the hospital’s infection control standards.

Upon completion of the project, the goal is that these badges will be available to all patient-facing staff and physicians at MGH.

“Practicing robust communication skills will benefit all our patients, even after the pandemic,� says Leah.