Communicative Access Measures for Stroke (CAMS) is a set of surveys that can help a healthcare facility or unit evaluate the degree to which it is communicatively accessible for people with stroke and aphasia. The term ‘communicative access’ refers to the ability of people with communication problems, like aphasia, to gain access to services through understanding verbal information, expressing their ideas, and making informed decisions about their health care.
CAMS consists of 3 online surveys that measure communicative access from different perspectives within the healthcare experience.
This survey targets the organizational and/or system level policies and procedures.
This survey targets attitudes and practices of frontline staff who provide service to people with communication barriers.
This survey targets service recipients to find out what people with aphasia experience in the way of communication barriers -- and relates this to their overall satisfaction with your services. To keep things simple, we have referred to CAMS3 as a “Patient Satisfaction Survey”, and service recipients as “patients”. However, CAMS3 can be used with anyone with stroke and aphasia that is receiving service (e.g. patients, clients, and residents.)
Here are the survey questions for the 3 CAMS surveys (PDF).
The CAMS website allows facilities and units to invite staff to fill out the surveys online.
CAMS is used to evaluate communicative accessibility in healthcare facilities and units providing services to individuals with stroke and aphasia. Responses from the CAMS surveys provide insight into how staff and patients can be better supported in communication within the healthcare environment. It can be a valuable quality improvement (QI) tool and inform the development of:
Facilities and units are free to use, report, or display CAMS data for health equity plans, accreditation planning, quality improvement, or continuing education needs assessments related to aphasia and stroke care. For example, data can be shown in quality improvement reports or presentations. For more details on what CAMS data can be used for, please see the Terms and Conditions.
Check out the published journal article that evaluates CAMS as a quality improvement tool targeting communicative access to information and decision-making for stroke patients with language disorders.
Kagan, A., Simmons-Mackie, N., Victor, J. C., & Chan, M. T. (2017). Communicative Access Measures for Stroke: Development and Evaluation of a Quality Improvement Tool. Archives of physical medicine and rehabilitation, 98(11), 2228-2236. https://doi.org/10.1016/j.apmr.2017.04.017
If you would like to use the CAMS suite of surveys for research purposes, you must ensure compliance with your organization's requirements regarding research projects, and notify the Aphasia Institute at research@aphasia.ca in advance.
CAMS collects survey data from healthcare staff on a unit or facility level (e.g. an inpatient stroke unit at a hospital). Units/facilities interested in measuring their level of communicative accessibility will designate one or multiple staff members to manage the use of CAMS. These individual(s) are referred to as the “CAMS Manager”. They do NOT have to be someone in a managerial position in their facility/unit.
After setting up your CAMS Manager account, you will be able to register their unit(s) to use CAMS and oversee the survey collection process. Survey data is collected over discrete periods of time, referred to as “survey rounds”. CAMS Managers can schedule survey rounds that last up to 6 weeks and invite staff members to complete any of the 3 surveys during that time.
A CAMS Manager can invite themselves to complete surveys they see fit. Invitations will be sent through email, and the recipients simply follow the links included to create an account and complete the surveys.
The CAMS3 survey is different from the other 12 surveys because it targets patients to find out what people with aphasia experience in the way of communication barriers and is facilitated by frontline staff using the provided pictographic resources and scripts. The collected responses are then entered online by staff.
Once the survey round is over, CAMS Managers are able to see their data and compare with previous survey rounds or the aggregated data of all CAMS users.
CAMS Managers are designated individuals overseeing a facility or unit’s use of CAMS. The CAMS Manager is often a unit manager or director, but does NOT have to be. It can be anyone who will be responsible for registering their facility/unit, sending survey invites, and accessing reports of aggregated survey responses. Ideally, it is someone familiar with the operations of a facility or unit to best support the implementation of CAMS.
CAMS Managers, also referred to plainly as “Managers” on this site, DO NOT have to be individuals in managerial positions in their facility or unit.
CAMS Managers can also complete surveys that may pertain to them. First-time CAMS Managers create their accounts on the CAMS website using the Create an Account function. Other users can also be invited to be Managers for facilities/units later on.
The requirements for CAMS will vary depending on which surveys you plan on using. For any use of CAMS, all users (CAMS Manager, invited staff, and surveyed patients) will need to provide informed consent and agree to the Terms and Conditions, which includes agreeing to share their responses in an aggregated and anonymized fashion.
The CAMS1 survey targets the organizational and/or system level policies and procedures. To complete it, you will need someone who is familiar with these policies or is able to find out. It takes approximately 5-10 minutes to complete and only 1 CAMS1 survey is completed in each survey round.
The CAMS2 survey asks staff about their attitudes and practices with regards to services for people with stroke and aphasia. There is no limit to how many staff are invited to complete this survey, but in order to protect staff privacy, the data for each question will only be viewable if a question has received at least 3 responses. This means Managers will need to invite at least 3 frontline staff members to complete CAMS2 for it to be useful. Since all survey questions are optional, some questions may still not have enough responses for the data to be shown, even if 3 or more staff are invited. The survey takes approximately 10 minutes to complete.
The CAMS3 survey asks about the experience of people with aphasia in the way of communication barriers and is facilitated by frontline staff using the provided pictographic resources and scripts. Staff facilitating this survey should have some expertise in supporting patients with communication difficulties. The time it takes to complete this survey will vary depending on the patient.
Reviewing this FAQ is a great start to using CAMS!
To get an even better understanding of how CAMS works and how to use it, please review this Overview for CAMS Managers PDF before creating an account. Once you’ve reviewed this package, then you can use the how-to guide to help you set up an account, create a facility/unit, start a survey round, and invite staff to complete the surveys.
We suggest discussing the use of CAMS with staff prior to creating survey rounds. A general recommendation of information for staff is provided in the Overview for CAMS Managers PDF
In the data report for each survey round, you will be able to see the percentage breakdown for each questions’ options. You will also be able to make internal comparisons between 2 survey rounds completed by your facility/unit, and external comparisons between your data and the aggregated data of all other CAMS users by different variables (type, region, country, or all data available) within a set time range of your choosing.
If you are part of an organization or network that has multiple facility/units, you could use your organization as the facility/unit for CAMS, thereby amalgamating all the facilities and units that are part of that organization, but generally speaking, it is not advised. While it is up to you how you would like to use CAMS, here are some things to consider:
CAMS operates on the level of facilities/units, so it is most appropriate for each facility/unit to be represented individually in CAMS, especially if facilities/units fall into different facility types (e.g., acute, rehab, community, etc.). Doing so makes comparing your data to aggregated data from all other CAMS users difficult.
If you decide to treat multiple facility/units as one in CAMS, you will not be able to separate the data out for each individual facility/unit. If you would like to do any comparisons of facilities and units you oversee, you should not treat them as one unit in CAMS.
It may be appropriate to treat multiple units as one in CAMS, if the units are the same type of unit (acute, rehab, community, etc.), and the units individually lack sufficient staff to meet suppression rules. For example, if you oversee 3 rehab units with limited staff (e.g. less than 3 in each), you may want to treat the 3 as one unit in CAMS.
More details are available in the
Overview for CAMS Managers PDF
If you have any other question regarding CAMS, please email cams@aphasia.ca