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Division of Speech and Hearing Sciences

Acute Care FOURC model

The Acute Care FOURC model is designed to establish early communication and participation for patients with neurologic communication disorders. Speech, language, and cognition abilities often evolve rapidly during acute care. Patients and family have significant information and communication needs, while SLPs have limited time to work with each person. The model operates through three intervention prongs to maximize impact. The same four goals are used for all patients and they are graded on a scale from 0 to 4 for degree of initiative and comprehensiveness. For most patients, the goal is a rating of 3 at the time of discharge. See resources below. A tutorial is under development.

Three Prongs

  • Intentional Strategies
  • Environmental Supports
  • Motivation and Confidence

Goals

  • Communication Experience
  • Comprehending Diagnosis(es)
  • Comfort, Safety, Preferences
  • Care and Discharge Planning

Resources for SLPs

Documentation and Outcome Measurement

Rating scale for outcome measurement FOURC Rating scale
Documentation template Documentation template

General Visual supports

Visual for talking about goal options Goal choices

Goal 1: Communication Experience

Visual for talking about hospital admission My Story
Checklist for communication supports Info In & Out handout
Information for family members Aphasia Institute: talking to your family member
Communication training resources for families CPT resources to use with families
Visual for referring to parts of body Black & White body

Goal 2: Comprehending Diagnosis(es)

Visual for talking about diagnoses Talking about diagnoses
Brochure for talking about aphasia What is aphasia?
Brochure for talking about stroke What is a stroke?
Brochure for talking about dysphagia What is dysphagia?
Brochure for talking about brain injury What is BI?

Goal 3: Comfort, Safety, Preferences

Checklist for comfort, safety, preferences Talking about preferences and precautions
Visual for explaining the call light Call light
Visual for explaining weight bearing precautions Weight bearing precautions
Visual for explaining IV precautions IV precautions
Visual for explaining feeding tube precautions NGT precautions
Visual for explaining safe swallow Safe swallow
Visual for comfort, safety, preferences (drawings) Preferences_Line Drawings
Visual for comfort, safety, preferences (photos) Preferences_Photos

Goal 4: Care and Discharge Planning

Visual for topics around discharge planning Discharge planning

Register to stay updated about the Acute Care FOURC model: click here

References:

Corwin M, Haley KL, Potocnik A, Reichneker C, & Tillson A. (2025). You can do that in a hospital?  Using the acute care FOURC model in treatment. Seminar to be presented at: American Speech-Language Hearing Association Annual Convention. Washington DC.

Potocnik A, Corwin M & Haley KL (2025, May). Acute care aphasia assessment & intervention: Applying the FOURC acute care model. Roundtable presented at: Clinical Aphasiology Conference, Albuquerque, NM.

Corwin M & Haley KL. (2025, May). Aphasia Assessment and Treatment in Acute Care Settings: Using the FOURC Model. Seminar presented at: Texas Speech-Language Hearing Association, San Antonio, TX.