1. Abstract Clear and accurate communication is an essential requirement within an integrated care team. Picture-based visual boards were used to improve the sharing of information between the clinical team as part of the Stroke Rehabilitation Pathway. Staff perception questionnaires were performed at pre-intervention, 6 weeks, 6 months and 12 months post introduction of the visual boards. 100% of staff reported the boards were an effective method of communicating a patients transfer and mobility requirements and had improved team collaboration. This was maintained at 6 and 12 months. Simple visual boards have improved communication of information between staff for patients transferring and mobility requirements. Improving communication in Stroke rehabilitation using simple visual information Richard Sealy Bsc (Hons.), Sara Gawned BSc & Mary Holland RGN Brodie Acute Stroke Unit and The Wolfson on Thomas Young: Neurorehabilitation, St George’s NHS Healthcare Trust, London Contact: richard.sealy@stgeorges.nhs.uk Introduction and Purposes A breakdown in communication has been shown to be a significant factor contributing to patient adverse incidents (Lee et al, 2012). A visual communication method was introduced to improve sharing of information relating to patients transfer and walking ability between clinical staff to prevent fall/adverse incidents during these tasks. Original Practice Pre-introduction there were several different methods of communicating a patients transferring and walking ability. The original practice consisted of:  Written documentation  Verbal handover  Demonstration Nursing and Physiotherapy teams working with stroke patients in the acute and rehabilitation setting completed a questionnaire (baseline) to measure their opinion regarding the current communication of an individuals transferring and walking requirements. This questionnaire identified:  Lack of awareness of how a patient should be transferring  Poor perception of approachability between clinical staff  Variability in the recording of transferring ability  80% of respondents fed back the current communication methods for patient transferring were ineffective Method The use of pictorial aids and visualisation media surrounds us through advertising and imagery. Image-based information has been shown to enhance memory and recall when compared to spoken and written language (Nesbit & Adesope, 2006). This cognitive strategy has also been shown to enhance an individual's problem solving and learning ability (Katz, 2006). It was decided to trial picture-based information as a medium to display information quickly, accurately and with minimal cost. Results Following introduction of the “Visual information boards”, all staff reported improved collaboration and joint working. Audits completed at 6 weeks, 6 and 12 months in the rehabilitation setting objectively demonstrate these improvements: 100% of respondents fed back a good perception of approachability between clinical staff with an increased awareness of how they should be transferring 88% stated a consistency in recording of transferring ability 100% of respondents fed back the current communication methods for patient transferring were effective References: Katz,G. (2006). Use of Pictorial Aids in Medication Instructions: A Review of the Literature. American Journal of Health- System Pharmacy, 63(23), 2391-2397. Lee, P., Allen, K. & Daly, M. (2012). A ‘Communication and Patient Safety’ training programme for all healthcare staff: can it make a difference? BMJ Quality and Safety, 21, 84-88. Nesbit, J. & Adesope, O. (2006). Learning with Concept and Knowledge Maps: A meta-analysis. Review of Educational Research, 76, 413-448 The authors would like to acknowledge the nursing and physiotherapy teams on Brodie Acute Stroke Unit and The Wolfson on Thomas Young for their role in this project. Conclusion Low cost and individually patient tailored visual information boards have improved communication and team working relating to patients transfers and mobility within the stroke pathway at St George’s Hospital. They now form an integral part of daily practice ensuring patients are consistently assisted to transfer and mobilise safely with the appropriate support and equipment further enhancing the teams rehabilitation approach. All transferring and mobility equipment that clinicians have access to were photographed, laminated and collated. This formed the central resource box that could be accessed by the physiotherapists at any time when a patient changed their transfer/mobility requirements. The visual information boards were clearly divided into transfer and mobility sections and were placed next to the patients bed. The physiotherapists continued to provide written documentation, verbal handover and demonstrations to the nursing staff for each patient. When a patient was discharged, the nursing staff would collect the images and return them to the central resource box.