Mrs Anna Roberts1, Ms Ester Mebalds1
1Peninsula Health, Frankston, Australia
Biography:
Anna Roberts is the Senior Speech Pathologist in Peninsula Health's 'At Home Subacute' team. Anna has extensive background across the Speech Pathology continuum of care for adults. She has worked in major Metropolitan and Regional hospitals across Acute, Subacute, Residential Aged Care and Community-based services. Anna is passionate about patient-focused care and developing service models that keep the patient at the centre. Anna was never very good at maths, but that hasn’t stopped her from loving spreadsheets, numbers, and Pivot Tables.
Abstract:
Ester Mebalds is the Allied Health Lead for At Home Subacute, and the supervisor of this project.
Subacute Bed substitution models are a new model of care in Victoria. To date, there is limited information about the Speech Pathology role in this setting. This study aims to evaluate a Speech Pathology service in a Subacute ‘At Home’ space. Data was collected over a 12 month period to track service demand and scope of practice, and patient-specific outcome measures.
232 data points were collected and analysed. 127 referrals received telephone-based intervention only, resulting in 300 contacts. 94 referrals received face to face intervention, with 244 home visits via Speech Pathology and 46 visits from Allied Health Assistants. The remaining referrals were managed through other means. Patients were seen on average 2.62 times during a 2-4 week admission, with a range of 1-16 home visits. Intensity of service was dependent on patient goals and therapy requirements. Aphasia and Dysphagia therapy were the most prevalent.
Standardised outcome measures (FIM/FAM) were taken on admission and discharge. There was average improvement of 0.4 (range 0-1) in a 7 point scale for 15/16 domains. Patients identified a range of personal goals which were later analysed using the GAS-light. 70% of patients achieved their goals, and 87% of patients achieved more than their anticipated goal. At discharge, 73% of patients did not require further intervention.
This study describes the range and nature of Speech Pathology service in a subacute bed-substitution model, and highlights the demand and value of patient-tailored therapy. The findings may be applicable to other health services providing this model of care.