Noisy places, outdoor spaces, mask requirements, and social distancing pose communication challenges even for those with normal hearing. The new C-Mics™ HearHooks™ offers up to 20 dB improvement in signal-to-noise ratios.1 This wireless system enables two-way communication via low-profile, clip-on talker/listener units (C-Mics) that direct speech into the ears by way of an open-ear earphone (HearHooks). The system offers up to seven hours of use on full-charge with an operating range up to 30 feet.
The product is available as a two-, four-, or six-unit system. The two- and four-unit systems are straightforward; the two-unit system is designed for two people while the four-unit system is designed for up to four people. The two-unit system includes two C-Mics and two binaural HearHooks whereas the four-unit system includes four C-mics and four binaural HearHooks.
The six-unit system is slightly different as it was designed specifically to accommodate the unique communication needs of the surgical environment. Precise communication must occur between the surgeon, circulating nurse, and anesthesiologist yet a host of confounding variables, including equipment noise and masking requirements, can make it difficult to communicate in an operating room. In addition, students often observe surgical procedures as part of their education and training; in these cases, students need to hear the communication amongst the surgical staff but not necessarily be heard. This is why the six-unit system comes packaged with four C-Mics, two Listener-only units, and six monaural HearHooks as it allows 2-way communication for up to four people with the ability to add two additional individuals as listeners only. These are sometimes used behind the glass up in the surgical control room, where students may be allowed to listen to a loudspeaker connected to one of the Listener-only units.
For more insight on the product, be sure to read these quick case studies compiled by Dr. Mead Killion including stories from a banquet,hiker, and physician. To place your order, contact Oaktree Products toll-free at 800.347.1960 or place your order online at OaktreeProducts.com.
References:
Killion, MC (2020). Problems understanding speech in noise: measurement, prevention and mitigation. Inaugural lecture of the Killion Lecture Series for the American Auditory Society, March 5, Scottsdale, AZ.
My colleague and friend, Dr. Angela Alexander, shares a personal story that inspired her passion and her goal to help more people understand Auditory Processing Disorder (APD). For nearly 20 years, she has helped hundreds of clients by evaluating and treating their auditory processing difficulties. While it may take a bit of courage to take that step, listen to her story. Wow.
Angela, thank you for your courage. Thank you for generating APD awareness. Thank you for sharing your story. Click HERE for more information on APD information and support.
Not that long ago, demand for disinfectant wipes outpaced supply, creating long delays in getting product in hand. As supply stabilized, inventory commitments made during the critical supply shortage period started coming in, creating an overstock situation of disinfectant wipes. Based on the current situation, here’s a stock investment tip when it comes to Opti-Cide MAX EPA-registered, hospital grade disinfectant wipes: buy now.
Opti-Cide MAX (160 disinfectant wipes per canister) is a broad-spectrum disinfectant with a 30-second to 1-minute kill time for most microorganisms. It’s low alcohol (20%) formula is safe on many clinical surfaces including acrylic, chrome, aluminum, and plastic. Here is the best news: during the month of August 2021, buy 6 canisters of Opti-Cide MAX get 6 additional canisters for free. The fast-drying formula has a 15-month shelf life with an expiration date of October 2022. Not only is there plenty of stock, you have plenty of time to use up the supply. Place orders on-line, via email (otp@oaktreeproducts.com) or phone (800.347.1960). Note: use item# SPEC-M60034 and enter quantity of 1 to purchase 6 canisters and to get 6 free (for a total of 12 canisters).
Patients perceive a more favorable rapport with providers, reporting the ability to better understand, engage, and connect with their provider when the provider chooses to wear a transparent mask over a solid face mask.1,2 Transparent masks offer adults with normal hearing and adults with varying degrees of hearing loss the benefit of improved speech understanding in noise compared to solid masks.3,4 One of the many lessons learned from COVID-19 is a heighted awareness of the role transparent face masks play in helping cultivate a positive patient experience. As the CDC continues to emphasize the need for health care providers and staff to wear masks, now is the time to stock up on these critical supplies.
For the next three days only (through July 31, 2021), save 20% on every box of ClearMasks purchased from Oaktree Products including ClearMask (item# Cm24), ClearMask Surgical (item# CM002Ez) and ClearMask KIDS (item# CM003EZ). Mention or apply coupon code CLEARMASK20 during check out. It’s Oaktree’s little way to say thank you and to keep you and your staff safe.
For more information on the benefits of transparent masks, see Benefits of Transparent Masks in the resource section of the Oaktree Products website. To place an order by phone: 800.347.1960; to place an order via email: otp@oaktreeproducts.com. For assistance with website login, call or email Oaktree Products to allow you to place orders online.
References:
Little P, White P, Kelly J, Everitt H, & mercer S (2015). Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations. British Journal of General Practice. 65(635), e351-e356. Available: https://pubmed.ncbi.nlm.nih.gov/26009529/
Saunders GH, Jackson IR, & Visram AS (2020). Impacts of face coverings on communication: an indirect impact of COVID-19. International Journal of Audiology. Available: https://pubmed.ncbi.nlm.nih.gov/33246380/
Schwarze ML & Kalbfell EL (2021). Benefits of clear masks in communication with patients. Journal of the American Medical Association, 156(4), 378-379.
Kratzke IM, Rosenbaum, ME, Cox C, Ollila DW, & Kapadia MR (2021). Effect of clear vs standard covered masks on communication with patients during surgical clinical encounters: a randomized clinical trial. Journal of the American Medical Association Surgery. 156(4), 372-378.
The industry-wide shortage of E-A-RLink disposable foam eartips created some pretty nasty B.O. (as in Back Orders). It has been frustrating for everybody but the wait is finally over!!! All SKUs of beige and yellow E-A-RLinks are back in stock at Oaktree Products, and can ship same day when the order is placed by 12pm CST. Never fear, remaining back orders were already picked, packed, and shipped carefully and quickly by the Oaktree Warehouse Team.
Today is the ideal time to take inventory of your ear tip supply while also stocking up on critical replacement parts including sound tubes and tube sockets. Trust me on the tube sockets….I wish I had a nickel for every time I disposed a used E-A-RLink with the tube socket still attached. Also, make sure you have a back-up plan by investing in a relatively inexpensive pair of headphones for audiometric testing (e.g. adult or pediatric RadioEar DD45 headset.).
Call Oaktree Products toll-free at 800.347.1960, email at otp@oaktreeproducts.com, or login to your account for easy ordering. For your convenience, a stock-up list for your reference:
Despite easing masks restrictions for fully vaccinated individuals, the CDC continues to emphasize the need for healthcare professionals, staff, patients, and visitors to wear masks in all health care facilities.1 Masks come in many forms including 3-ply surgical, N95 and KN95 respirator, cloth of varying fabric, and transparent with clear panels or windows. While serving an important role in minimizing the spread of the SARS-CoV-2 virus, these products make understanding speech particularly challenging when working with children or with individuals with communication disorders like hearing loss or aphasia. The challenges are exacerbated in the presence of noise and/or increased distance between the listener and the speaker.2-3
General Challenges of Masks on Speech Understanding:
All masks, including transparent products with clear panels/windows, noticeably reduce speech loudness and simultaneously degrade speech quality by disproportionately attenuating higher frequency sounds needed for understanding speech. Speech reduction involves frequencies above 1KHz with most of the reduction occurring above 4 KHz.4 The degree of high frequency attenuation depends on the type of mask and reportedly ranges from 2.3 dB5 to as high as 21.2 dB.2 Corroborated by several studies, transparent exhibit greater attenuation compared to other traditional masks.2,4-6 In other words, transparent masks muffle speech more than other face masks and may lend credence to the conclusion that transparent masks may not facilitate effective communication between a health care provider and patient. On the contrary, despite greater acoustic effects on speech signals, transparent masks yield quantifiable benefits over traditional face masks for patients with hearing loss and/or other communication disorders.
Benefits of Transparent Masks:
Preservation of Visual Cues
The provision of both audio and visual cues offers a significant advantage as it helps listeners segment portions of speech better than audio only cues7 and recognize speech better in the presence of background noise.8 Traditional surgical and cloth masks obscure facial structures including the lips, tongue, and teeth. Loss of visual cues removes the ability for the listener to lipread and visualize facial expressions, both which augment the ability to understand speech. Individuals with hearing loss rely much more on visual speech cues than normal hearing counterparts, particularly when the speech signal is degraded.9-11 Elimination of visual speech cues degrades speech intelligibility by as much as 20% in the presence of a moderate sensorineural hearing loss.12 For these reasons, advocates pushed for the CDC to issue guidance on the use of masks with transparent panels for those with hearing loss13 although recent studies offer compelling evidence of the benefits of transparent masks over solid masks on speech understanding.
A preliminary study by Yi and colleagues (2021) found that normal hearing listeners correctly identified more words in noise when the speaker wore a transparent mask versus a solid mask.14 Two other studies included subject groups with hearing loss, yielding similar results. In a comparison study, Atcherson et al (2017) found improved speech understanding performance in noise for two groups of listeners with hearing loss (moderate and severe-to-profound) with a prototype transparent mask over a traditional surgical mask.8 More recently, Thibodeau and colleagues (2021) found significantly better recognition of sentences in the presence of background noise with a transparent mask than with a solid mask.15 Access to visual cues via a transparent mask provides a significant advantage to the listener with normal hearing or hearing loss, yielding significantly better speech recognition accuracy in quiet or noise as compared to solid masks.
Minimal Negative Impact on Delivery of Services
Traditional masks negatively impact the delivery of healthcare services by limiting the ability for some clinicians to execute rehabilitative or habilitative therapies. For example, speech therapy requires speech-language pathologists to provide appropriate cues on proper speech production.16 Treatment options for individuals with other communication disorders often integrate face-to-face services, whether in-person or remotely, where visual access to the therapist’s mouth remains essential. Traditional masks obscure the lower half of a speaker’s face by blocking visualization of full facial expressions and all lip movements. Solid masks inherently preclude speech-language pathologists from executing traditional treatment options whereas transparent masks do not.
Increased Patient-Perceived Rapport with Providers
Non-verbal communication in the form of facial expressions represents an important aspect of communication.17 When asked to rate the difficulty solid face masks impose on communication, individuals reported much greater difficulty understanding, engaging, and connecting with their provider during appointments.18 Research shows that patients are more likely to report significantly more favorable ratings in situations where the provider wears a transparent or clear mask.19 In a randomized clinical trial of 200 patients, surgeons were perceived as better communicators when wearing transparent masks compared to covered masks, and rated significantly higher by patients for providing understandable explanations, demonstrating empathy, and building trust.20
Summary of Transparent Mask Benefit:
Transparent masks are specifically designed to preserve access to visual cues, offering the following benefits over solid masks:
improved speech understanding in noise for adults with normal hearing;14-15
improved speech understanding in noise for adults with varying degrees of hearing loss;2,15
minimized negative impact on delivery of services,13
more favorable patient-perceived rapport with a healthcare provider;19
significantly higher patient ratings of provider’s ability to offer easy-to-understand information,19-20
significantly higher patient ratings of provider’s ability to display empathy,19
significantly higher patient ratings of provider’s ability to build trust.19-20
Conclusion:
Despite attenuating high frequency speech sounds the most, transparent masks offer a significant advantage over solid masks. Transparent masks preserve access to a speaker’s lips and facial expressions, resulting in quantifiably significant improvements in speech recognition accuracy in both quiet and noise by individuals with either normal hearing or with varying degrees of hearing loss. Furthermore, transparent masks facilitate increased patient-perceived rapport. Providers using transparent masks are rated as better communicators and more trustworthy. Given the communication benefits of transparent masks over solid masks, speech-language pathologists and audiologist should consider donning transparent masks during the delivery of services.
Atcherson SR, McDowell BR, & Howard MP (2021). Acoustic effects of non-transparent and transparent face coverings. Journal of the Acoustical Society of America, 149(4), 2249-2254.
Wolfe J et al (2020). Optimizing communication in school and other settings during COVID-19. Hearing Journal, 73(9), 40-45.
Corey RM, Jones U, & Singer AC (2020). Acoustic effects of medical, cloth, and transparent face masks on speech signals. Journal of the Acoustical Society of America, 148(4), 2371-2375.
Bottalico P, Murgia S, Puglisi GE, Astolfi A, & Kirk KI (2020). Effects of masks on speech intelligibility in auralized classrooms. Journal of the Acoustical Society of America, 148(5), 2878-2884.
Mitchel AD 7 Weiss DJ (2013). Visual speech segmentation: using facial cues to locate word boundaries in continuous speech. Language Cognition and Neuroscience, 29(7), 771-780.
Atcherson SA et al (2017). The effect of conventional and transparent surgical masks on speech understanding in individuals with and without hearing loss. Journal of the American Academy of Audiology, 28(1), 58-67.
Walden, BE, Montgomery, AA, Prosek, RA., & Hawkins, DB (1990). Visual biasing of normal and impaired auditory speech perception. Journal of Speech and Hearing Research, 33, 163–173.
Desai S, Stickney G, & Zeng FG (2008). Auditory-visual speech perception in normal-hearing and cochlear-implant listeners. The Journal of the Acoustical Society of America, 123, 428–440.
Stacey P, Kitterick P, Morris S, & Sumner C (2016). The contribution of visual information to the perception of speech in noise with and without informative temporal fine structure. Hearing Research. 336, 17-28.
Bannwart Dell’Aringa AH, Satico Adachi E, Dell’Aringa AR (2007). Lip reading role in the hearing aid fitting process. Revista Brasileira de Otorrinolaringologia (Brazilian Journal of Otolaryngology). 73(10), 101-105.
Yi H, Pingsterhaus A, & Song W (2021). Effects of wearing face masks while using different speaking styles in noise on speech intelligibility during the COVID-19 pandemic. Frontiers in Psychology. Available: www.frontiersin.org/articles/10.3389/fpsyg.2021.682677/full
Thibodeau LM, Thibodeau-Nielsen RB, & Quynh Tran CM (2021). Communicating during COVID-19: the effect of transparent masks for speech recognition in noise. Ear and Hearing, 42(4), 772-781.
Little P, White P, Kelly J, Everitt H, & mercer S (2015). Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations. British Journal of General Practice. 65(635), e351-e356. Available: https://pubmed.ncbi.nlm.nih.gov/26009529/
Saunders GH, Jackson IR, & Visram AS (2020). Impacts of face coverings on communication: an indirect impact of COVID-19. International Journal of Audiology. Available: https://pubmed.ncbi.nlm.nih.gov/33246380/
Schwarze ML & Kalbfell EL (2021). Benefits of clear masks in communication with patients. Journal of the American Medical Association, 156(4), 378-379.
Kratzke IM, Rosenbaum, ME, Cox C, Ollila DW, & Kapadia MR (2021). Effect of clear vs standard covered masks on communication with patients during surgical clinical encounters: a randomized clinical trial. Journal of the American Medical Association Surgery. 156(4), 372-378.
By the time a patient walks in your front door, you’ve already invested significant time, money and resources to get them there. To optimize this investment, you want to reinforce their decision to choose your practice and help them move forward in their decision to improve hearing health. This means using your practice environment to focus patients on their hearing health and educate and engage them so they are active participants throughout the entire appointment. You want to keep them focused on positive emotional triggers and the benefits of hearing health and use every second they are in the practice intentionally.
First Impressions Matter — A LOT!
So, how do you intentionally create an engaging reception area? First, you want to understand what your patients see. You want to maximize the investments you’ve made to get your phone to ring and capitalize on those moments in the waiting room. Even if it’s for a few minutes, that is precious, powerful time that you have to engage and interact with your patients while they wait.
Your reception area provides you the opportunity to make your patients feel appreciated, valued and respected.
To Do: Conduct a Reception Area Assessment
Walk outside your clinic and walk through the door through the eyes of your patient
Assess your clinic from all the senses — including sight, sound, feeling and smell. Start from the ceiling to the floor.
Look for the “little things” that patients notice and could impact how their view your practice including dust, cobwebs, clutter, temperature, organization and even outdated magazines.
Look for the big things, too, including seating arrangements, accessibility, design and décor.
Make sure there are, at a minimum, 3 resources easily available for patients to learn more about hearing health such as magazines, brochures and waiting room “info-tainment” playing on a television.
And finally, be excellent in the way the patient is greeted, seated and made to feel welcome by your team. Every patient contact should be intentional.
After you’ve completed the assessment, prioritize the changes and improvements that need to be made, assign a champion, completion date and resources, including time and money.
Create Content to Increase Understanding
Your patients do not come to you to purchase a hearing aid. They come to you because you can help them remain involved, active and connected to other people. They are looking to you to help them understand their hearing problem, understand the solutions available and understand how they can overcome any barriers to purchase, such as cost, timing and fear. This means your team must be ready and able to answer questions and provide relevant information. To do this, consider using the 10-10-4 Strategy. This strategy should be done as a team and is the ideal way to be prepared to help patients along their decision-making process by answering patient concerns and providing answers to “unasked” questions.
TO DO: Implement the 10-10-4 Strategy
Write down the top 10 questions patients ask on a regular basis and the “best answers” to those questions.
Write down the top 10 questions your patients should be asking you but aren’t, along with the “best answers.”
Create 4 additional key content pieces that would be meaningful to your patients.
Call to action: what do you want patients to do next in every decision-making point along their journey?
Portal for more: make sure your patients know your web address and place specific key information that answers the 10 most frequently asked and 10 “should be asked” questions.
Appreciate in advance: let your patients know — in advance — that you appreciate them taking their hearing health journey with you. Our CDM TV OnDemand service brings your patient education system to your patients in the home. With a simple URL link, you can deliver all of the awesome educational content and custom video content to your patients in an email or embed it on your website.
Added value: make sure patients know all the great services and added value you deliver, such as a battery program, auditory therapy or financing.
Don’t Just Educate. Inspire!
Reception area “info-tainent” is one of the most effective ways to educate patients about hearing health and your practice. If you have a television but are currently using it solely to entertain by playing the Travel Channel or Food Network you are missing a great opportunity. Our company contracted Accent House Research to conduct a waiting room impact study. They found 93% of the doctors that participated indicated that their patients asked much more thoughtful questions after viewing digital signage or digital video in the waiting room. Because video/television engages several senses (hearing and vision), it is a great way to not only educate but also inspire patients. When you create your own video, you control the content and can tell your story. You can introduce your team and their passions in life. You can share patient testimonials as social proof that other lives have been improved because of care and the hearing health solutions you and your team provide. Finally, you can ensure patients are exposed to content that will validate their decision to choose you for their hearing health and help them make great hearing health choices. Remember, repetitive messaging will enhance retention and understanding. So make sure the content you created from your 10-10-4 Strategy are included as content on your video “infotainment,” website and displays throughout your practice.
Michele Ahlman is CEO of Clear Digital Media, an Austin, TX-based privately held company that prides itself in providing high-quality, educational content to healthcare providers’ waiting rooms. Michele is responsible for leading the development and execution of both long and short-term strategies and strategic partnerships. With vision, passion, and commitment this privately held, family run, women-owned company creatively, stylishly and economically transforms healthcare waiting rooms into a powerful patient engagement tool. As CEO and company cheerleader, Michele’s goal is to provide a great waiting room experience that gives patients an opportunity to learn about their health, their clinic, and the latest healthcare trends. She believes that being informed is an essential part of an enjoyable life and is dedicated to delivering it in the most ingenious ways.
The Welch Allyn LumiView Clear Specula is new and totally worth checking out. Why? The disposable specula are transparent, providing a much brighter field of view than the opaque specula we are all used to using. Since the otoscope light shines through the specula, the light output is 4X – 8X greater in the ear canal than traditional adult and pediatric specula respectively. Compatible with the Welch Allyn MacroView, Digital MacroView, 3.5V Diagnostic, and Pocket otoscopes, the LumiView Clear Specula are available by the bag (850 specula) or sleeve (34 specula) at the same price as traditional disposable Welch Allyn diagnostic specula.
Order adult and/or pediatric size Welch Allyn LumiView Clear Specula from Oaktree Products by calling toll free 800.347.1960, sending an email to otp@oaktreeproducts.com, or logging into your account on the Oaktree Products website. These new specula are cool, cost the same as what you are already using, and make it easier to see what you need to see!
