Authors (including presenting author) :
LAI J(1), NGAN C(1)
Affiliation :
(1)Speech Therapy Department, Ruttonjee and Tang Shiu Kin Hospitals
Introduction :
Before December 2017, inpatients of Cheshire Home, Chung Hom Kok (CCH) referred for Speech Therapy (ST) needed to attend Pamela Youde Nethersole Eastern Hospital ST as outpatients. Hospital staff had to escort patients and hospital transportation was required for the consultation in ST outpatient clinic.
Since December 2017, pilot provision of one session per month in-house ST service at CCH was commenced by ST from RTSKH, which was increased to two sessions per month from 1 April 2019 and to five sessions per week from 23 September 2019 onwards.
Objectives :
To improve access to Speech Therapy inpatient service at CCH and ensure swallowing safety of CCH patients.
Methodology :
Since the pilot ST service provision, priority is put on the dysphagia management. To evaluate the service demand, the average number of new attendances per month, the average waiting time for assessment and the time between initial assessment and follow up will be used. Clinical outcome will be evaluated by the change in diet tolerated by patients.
Besides, education on swallowing management was provided to nurses and patient care assistants in order to enhance their knowledge and skills in handling patient’s swallowing difficulties.
Result & Outcome :
The service statistics and clinical outcome were compared between 1/4/2019-22/9/2019 and 23/9/2019 to 31/12/2019:
The enhanced ST service at CCH resulted in an increase in the number of new attendances per month from 3 to 12. The average waiting time for assessment was shortened from 33 days to 3 days. The average time between initial assessment and first follow-up was also shortened from 72 days to 9 days.
A total of 76 inpatients were seen since the service commencement. After ST assessment, 4/76 patients (5.26%) were able to wean off tube feeding after therapy. 1/76 patients (1.32%) found to have aspiration risk in swallowing and was suggested tube feeding. 51 patients sustained oral feeding throughout therapy and 30/51 (58.82%) had diet changed.
Conclusion:
The establishment of in-house ST service at CCH not only enhances patient’s access to speech therapy service but also relieves the pressure on staff manpower for escort and transport of patients to out-patient ST clinic. Patient’s swallowing safety and quality of life was improved by the in-house ST service provision and the staff’s knowledge in managing swallowing difficulties.
