Objective: People with Communication Disabilities (PwCD) often face poorer health outcomes and lower satisfaction with healthcare services, partially due to environmental barriers. This study examined environmental elements in healthcare settings that impact communication accessibility for PwCD. The lack of research examining the influence of healthcare environments on communication accessibility prompted this study. By identifying environmental barriers and facilitators, this research aims to inform changes that can improve healthcare outcomes for PwCD.

Methods: An inductive, qualitative research design was employed, utilising visual data analysis and reflexive thematic analysis. A total of 160 images and videos were collected from four healthcare settings: metropolitan and rural services spanning oral health, emergency and perioperative care. A subset of 14 images and 2 videos was purposefully selected to represent the diversity of healthcare settings and experiences. Content analysis was performed to categorise the images and videos into descriptive categories, followed by visual data analysis to generate descriptions of the visuals. Reflexive thematic analysis was then conducted to uncover meaningful themes related to communication accessibility.

Results: Thematic analysis of the visual data actively produced four key themes: (1) wayfinding is a significant challenge in navigating healthcare environments, (2) well-intentioned efforts do not always meet the desired outcomes, (3) there are opportunities for small changes with big impacts and (4) cultural diversity and inclusion need greater attention. These themes reflect several critical areas for improvement to ensure communication access is optimised in healthcare environments.

Conclusion: The findings underscore the urgent need for healthcare settings to prioritise inclusive communication. Implementing small-scale, targeted changes in the healthcare environment can lead to substantial improvements in communication access, potentially fostering better health outcomes and more inclusive experiences for all patients. Findings may not be generalised or applicable to all healthcare services.

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