Show Me Where

Developed by staff at Cardiff and Vale University Health Board, Show Me Where (SMW) is a simple tool with an indispensible use: it allows patients to communicate in difficult circumstances and quickly indicate the location of their pain.

About Show Me Where

Show Me Where, a pain communication tool created by Cardiff and Vale UHB staff members, is transforming the care of vulnerable adults and children who have barriers to communication.

Created to allow patients to communicate via visual and physical rather than verbal means, the Show Me Where fan tool is made up of a series of lightweight and sterilisable polypropylene sheets that each feature an illustrated body part. It’s easy to attach to staff uniforms or a patient’s bedside, ensuring that patients are given the chance to communicate in the way that’s most comfortable for them when they’re at their most vulnerable.

The effects of Show Me Where are far reaching for clinicians and carers. The tool allows clinicians to inform patients where they will be examined and to gain their consent, thus reducing anxiety and improving understanding. The tool also takes the guesswork out of finding the site of pain for nursing assistants, parents and carers, allowing them to report to medical staff more effectively.

Its usefulness has been established for a number of patient groups including those with learning disabilities, stroke patients, intubated and tracheostomy patients, those with disabilities that affect their speech (cerebral palsy, multiple sclerosis), people with early stage dementia, and patients with hearing problems. It’s also proved to be an important communication aid for non-English speakers.

Transformation in Action

The idea for Show Me Where began with Irene Hammond, a now-retired nurse who wanted to improve the lines of communication between children with autism and those who care for them. Autistic children often have issues with contact and may be oblivious to injury, so delay indicating when in pain. Irene wanted to offer them a simple visual intervention that allowed them to easily pinpoint their discomfort and report in the third person without drawing attention to themselves.

Irene joined forces with Jan Sharp, Senior Medical Artist at Cardiff and Vale UHB, to design and produce the physical product.

Soon afterwards, support and funding was secured from the South East Wales Academic Health Science Partnership (SEWAHSP) to create the Show Me Where app, an even more intuitive way to connect the carer to the clinician. Available from the App Store and Google Play, the multilingual app had the addition of a list of symptoms that work with the body images and features translations from six of the most widely-spoken languages in Wales – Welsh, Somali, Polish, Urdu, Bengali and Arabic – to further open the lines of communication for all with access to a smart device.

Last year, Jan and Irene pitched their progress to the joint Cardiff University and UHB Innovation MDT, based in the Cardiff Medicentre. Shortly afterwards a commercial partnership was formed with Focus Games, a company that sells health related education games, to enable far-reaching distribution. It’s now been adopted as far away as Melbourne, Australia!

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Jan’s Story

Jan Sharp is a Medical Illustrator (IMI, AHCS) at Cardiff and Vale University Health Board. She’s worked at the University Hospital of Wales for over 35 years, providing medical and surgical artwork that aids teaching and provides valuable information for patients and the public.

“I joined the University Hospital as a medical illustrator in 1982. I’ve been involved in a variety of interesting medical projects, and Show Me Where is one example.

“Irene Hammond, a nurse working at The Hollies special school, had noticed that children with autism had difficulties accurately reporting pain, her new idea enabled them to to show where they hurt and report pain and by using body images. Working together as a team, we applied for funding to design and develop ‘Show me where’ into a multi-lingual app containing 6 languages and plastic fan tool, enabling adults and children with autism and any other verbal disability, to indicate the site of pain quickly and help their carers to communicate effectively with medical staff.

“Show Me Where is now used routinely and successfully in special schools in Wales and further afield and is endorsed by the National Autistic Society

“With the help of the Clinical Innovation team Show Me Where now has a commercial partner, Focus Games, an educational games company who look after sales and distribution, which in turn provides an income for Cardiff and Vale UHB.

“It has been an exciting journey to get SMW to market, producing the artwork, choosing the correct print for the product, designing the navigation of the app, recording of different languages and working with the coding team. Also working with our audience of patients, carers and staff who benefit from using Show Me Where, helping non-verbal people communicate.”

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