Mrs Anneliese Wegener1, Ms Nicolette Varvounis1
1Northern Adelaide Local Health Network, Australia
Biography:
Anneliese Wegener is a Senior Speech Pathologist at the Lyell McEwin Hospital in the Northern Adelaide Local Health Network. She has been working as a Speech Pathologist since 2016 with experience in assessment and management of adults with swallowing and communication disorders in the acute setting and voice disorders in the outpatient setting. She is currently working primarily within the ICU and general medical wards at the Lyell McEwin Hospital, overseeing adult outpatient clinics and providing supervision to junior staff members. Anneliese has a particular interest in student supervision, videofluoroscopy swallow studies, stroke and palliative care.
Nicolette Varvounis is the Senior Manager of Speech Pathology for the Northern Adelaide Local Health Network which includes leadership of adult and paediatric Speech Pathology services in the acute and community settings. Nicolette has been working as a Speech Pathologist since 2009 with professional background primarily including broad experience with the adult population presenting with swallowing and communications disorders in the acute setting.
Abstract:
Patients referred to NALHN with voice disorders or chronic cough are seen by a Speech Pathologist within the Voice Outpatient Clinic. The clinic operates once a week, offering one new and four review appointments for voice therapy. Over the years, several challenges have emerged, including high did not attend (DNA) rates, long waitlists and disruptions caused by COVID-related clinic closures.
To improve efficiency, two key changes were implemented. First, a waitlist verification was conducted every six months to determine whether patients waiting >180 days still required an appointment, with those not responding within 21 days being discharged from the waitlist. Second, initial appointments (where possible) were booked as phone consultations, informing patients about therapy expectations and required commitment levels. Discharge was offered to those whose difficulties had resolved or could not proceed with therapy expectations
These strategies led to a significant reduction in wait times, total patients on the waitlist, and DNA rates. In April 2019, there were 53 patients on the waitlist, with a longest wait of 320 days. By February 2025, this had decreased to 24 patients with a longest wait of 217 days. While there was an increase in DNAs during peak COVID in 2021-2023, the clinic saw an overall trend down from a DNA rate of 19% in 2018 to 9% in 2024.
Clinicians found that phone consultations addressed many patients’ concerns through education and strategies, often reducing the need for ongoing appointments and therefore decreasing the overall caseload.