By: Teja Pritchard
Richard Hurtig, professor emeritus and former department chair in the Department of Communication Sciences and Disorders in the College of Liberal Arts and Sciences, recently delivered a keynote presentation remotely at the Eighth International Speech-Language Pathology Summit Forum in Jinan, Shandong Province, China.
This year's forum, themed "Standards, Responsibilities, and Innovation," gathered leading scholars and clinicians to exchange ideas, share expertise, and shape the future of the field.
Hurtig's work focuses on supporting patients in intensive care units (ICUs) who face significant communication challenges due to their medical condition, inability to access nurse call systems, or language barriers. These challenges can lead to preventable adverse medical outcomes. To address these issues, Hurtig has pioneered assistive technologies to empower patients to effectively communicate with their care providers.
In his presentation, “Utilizing assistive technology to overcome communication barriers in intensive care settings,” Hurtig' highlighted the devices he developed that have transformed ICU experience for patients by giving them a voice during critical moments.
In this Q&A, discover Hurtig’s research, his keynote presentation, and what drives his work.
What inspired you to dedicate your work to improving communication for ICU patients?
Over most of my career, I was engaged in studies of the perceptual and cognitive basis of language. To accomplish this, I needed to develop a range of tools to present study participants' speech samples and to record their responses. My clinical colleagues in the department reached out to me to see whether I could adapt some of the circuits I had designed with Bruce Clark, who oversaw the department’s electronics shop.
That led to several specialty switches and speech generating devices for children and adults with developmental disorders as well as for systems for ALS patients. By chance, some of the nurses working in the UI Health Care intensive care units had heard of my work and contacted me to see if I could adapt my circuits to allow some of their mechanically vented spinal cord injury patients to access the nurse call system. Those individual experiences in our clinic and in the UIHC ICUs lead to my “late career” commitment to address the complex communication needs of hospitalized patients.
Can you describe the most significant way your assistive technologies, like noddle, have changed a patient's experience in the ICU?
After my initial involvement with ICU patients, it became clear that it would not be feasible to just continue to build “one offs.” What was needed was something that the nurses and the SLPs could quickly deploy, and that could be used with the wide array of patients and address their specific barriers to effective patient-provider communication.
Working with the CSD and biomedical engineering students in my AAC lab, I developed the patented noddle smart switch and the noddle-chat communication tablet. The gesture detecting and counting algorithms of the noddle enable patients, who might only be able to produce a single intentional gesture, to be able to summon help and effectively communicate about their needs.
To address communication barriers faced by patients with limited English proficiency, I developed bilingual versions of the noddle-chat communication tablet. Our NIH-supported clinical trials demonstrated that introducing assistive technology into the ICU improved patient outcomes and reduced both patient and caregiver stress.
How did your work at the University of Iowa influence the insights you shared in your keynote presentation?
The combined efforts of my lab, together with UI speech-language pathologists (SLPs) and the UIHC ICU staff, demonstrated that addressing the communication needs of all hospitalized patients is essential to improving patient outcomes.
When the COVID-19 pandemic restricted who could be at the bedside and what assistive technology could be brought into the ICUs, my colleagues and I at the Patient-Provider Communication Network developed low tech communication tools that made it possible for the patients to communicate and participate in their care.
If there is one key message you want attendees of your remote keynote in China to take away, what would it be?
SLPs have a critical role to play in building a “culture of communication” that will ensure that patients can effectively summon help and communicate with their caregivers and become active participants in their care.
What does it mean to you to be invited as a keynote speaker for such a significant international forum?
It is nice to see a growing worldwide interest in having hospital based SLPs addressing the broad communication barriers faced by patients and not just evaluating their dysphagia.