Table 3.

Accommodations and descriptions organized by their function and socioecological level targeted.

Socioecologic level targeted	Function		Accommodations	Description based on studies reviewed
Patient	Augment patient communication		Augmentative and alternative communication aids (AAC aids)	Use of picture, symbol, word boards, or assistive technology to support communication. Examples included the Noddle switch and chat tablet by Voxello for patients on mechanical ventilation (Hurtig et al., 2019) and iPad with picture menus for patients with aphasia (Francis et al., 2021)
			Hearing amplifier	A device that amplifies incoming speech to the wearer to support hearing and reception (e.g., Chodosh et al., 2021)
			Voice amplifier	A device worn by the speaker to increase their volume to support vocal expression (e.g., Wong et al., 2021)
	Integrate family support		Patient–Family Agenda Tool	A checklist completed by patients and care partners prior to the appointment, to specify the communication role of the care partner in the medical appointment and the patient's medical agenda. The Patient–Family Agenda Tool prompt was “How can your family member or friend be most helpful today?”. Example options included: “Listen to what the doctor says and take notes,” or “Help you understand what the doctor says or means” (Wolff et al., 2021)
Provider	Adapt provider communication		Communication strategies	Providers employing strategies such as slowing down, providing options, asking yes/no questions, writing key words. For example, the KomHit program (Hansen et al., 2022).
Clinic or health care organization	Infrastructural capacity and supports for communication access	Identify patients with communication disabilities, tailor, and convey accommodation needs to health care team.	Systematic identification of CD and needs	Systematic, routine identification of accommodation needs by a clinic or health system as a first step leading to provision of accommodations. For example, registration staff screening and documenting all new patients using the question, “Due to a disability, do you need any additional assistance or accommodations during your visit?” (Morris et al., 2021)
			Customized plan	Specifies accommodation needs, individualized to the patient. It is created by a skilled provider or the patient, for health care team members to read and implement. For example, in the AASPIRE Healthcare toolkit, patients created a personalized accommodations report for their providers (Nicolaidis et al., 2016).
		Modify policies and processes of health care delivery affecting communication	Adapted written health materials	Written health materials provided by the clinician/organization that were modified to increase accessibility for communication disability populations. For example, one study developed the Communication Aid to Capacity Evaluation (CACE), a pictorial + simplified wording format version of a standardized capacity evaluation, for persons with aphasia (Carling-Rowland et al., 2014).
			Virtual visit	A health care visit conducted virtually (e.g., Selick et al., 2023)
		Both	Learning disability nurse	Learning disability nurses (LDNs) specialize in caring for people with intellectual and developmental delays. They serve as an advocate, navigator, coordinator of accommodations and care modifications and mediator of complex medical communication to patients (e.g., Castles et al., 2014). In all studies included, they practiced in the United Kingdom or Europe.

Note. CD = communication disability.