Aug 13, 2015

SPEACS 2: Improving Patient Communication and Quality Outcomes in the ICU

The purpose of this research was to test the impact of a unit-wide program (SPEACS-2) of nurse training, speech language pathologist collaboration and “low tech” communication materials on nursing care quality, clinical outcomes, and cost. This brief examines effects on patient experience of communication, nurse and family outcomes, and cost-utilization outcomes (secondary aims).


  • Each year, in the U.S., more than 800,000 critically ill patients are unable to speak with artificial airways and ventilators during treatment.
  • Unmet communication needs are the most common source of distress reported by patients, leading to anxiety, panic, and frustration, placing them at greater risk for preventable adverse events.

Key Findings

  • Nursing knowledge, comfort, and satisfaction regarding communicating with mechanically ventilated patients showed improvements after the SPEACS-2 program was implemented.
  • There was no change in patient-family perceptions of communication difficulty or satisfaction with communication. Families reported use of communication boards more often after the intervention but with low frequency.