Establishing a Multidisciplinary Head and Neck Clinical Pathway: An Implementation Evaluation and Audit of Dysphagia-Related Services and Outcomes

AbstractHead and neck cancer (HNC) guidelines recommend regular multidisciplinary team (MDT) monitoring and early intervention to optimize dysphagia outcomes; however, many factors affect the ability to achieve these goals. The aims of this study were to explore the barriers/facilitators to establishing and sustaining a MDT HNC care pathway and to examine the dysphagia-related speech-language pathology (SLP) and dietetic components of the pathway. Using the Consolidated Framework for Implementation Research (CFIR), a mixed methods study design was used to evaluate an established MDT HNC pathway. Ten MDT members provided perceptions of facilitators/barriers to implementing and sustaining the pathway. Patients attending the SLP and dietetic components of the pathway who commenced treatment between 2013 and 2014 (n  =  63) were audited for attendance, outcome data collected per visit, and swallowing outcomes to 24-month post-treatment. Dysphagia outcomes were compared to a published cohort who had received intensive prophylactic dysphagia management. Multiple CFIR constructs were identified as critical to imple menting and sustaining the pathway. Complexity was a barrier. Patient attendance was excellent during treatment, with low rates of non-compliance (
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

Related Links:

.
Source: International Journal of Speech-Language Pathology - Category: Speech-Language Pathology Authors: Source Type: research
When a toddler presented with a raspy voice, pediatricians initially suspected respiratory infections, dysphonia and then acid reflux. But, as revealed in a “Mystery Diagnosis” column in the Washington Post, the problem was much more serious. A pediatrician initiated acid reflux treatment and referred the little girl, who had experienced voice problems since birth, to a a pediatric otolaryngologist.  The ENTs investigations revealed a diagnosis that shocked the girls’ parents: She had a rare disease—recurrent respiratory papillomatosis. Caused by two strains of the human papilloma virus (HPV)&m...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care News Slider Speech-Language Pathology HPV Voice Disorders Source Type: blogs
The objectives—and perhaps even more interesting, the disparities within the objectives according to sex, educational attainment and disability status—are tracked by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics. We can search the CDC’s database by topic area for additional data on health care disparities. While the government works toward the Healthy People initiative, we can help improve health care access for those with communication disorders in our communities. I started by considering people’s social determinants of health in my community an...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Audiology Health Care Private Practice Slider Speech-Language Pathology hearing loss Language Disorders Speech Disorders Source Type: blogs
Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers&m...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Slider Speech-Language Pathology Dysphagia Source Type: blogs
Recently, an article was published in the Leader about my work with patients with head or neck cancer. The response has been great, with the most-asked question being about the pathway I created to help patients and caregivers navigate through and receive improved access to care. How did I create this pathway? The first thing I did was listen to patients and caregivers discuss what they wished they knew before treatment started. After years of listening, I realized something had to change for them. From this realization came the idea of designing a pathway so all treating partners—as well as patients and caregivers&m...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Slider Speech-Language Pathology Dysphagia Source Type: blogs
Conclusions Even after controlling for age, gender, health, and disability, communication impairment is a significant independent predictor for key aspects of the social function of older adults and demonstrates two distinct pathways to loneliness and depression. Supplemental Material https://doi.org/10.23641/asha.7250282. PMID: 30950760 [PubMed - in process]
Source: Journal of speech, language, and hearing research : JSLHR - Category: Speech-Language Pathology Authors: Tags: J Speech Lang Hear Res Source Type: research
Upon completion, participant will be able to identify methods for increasing referral rates for Speech Language Pathology services for Head and Neck Cancer patients undergoing radiation therapy.
Source: Journal of the American Dietetic Association - Category: Nutrition Authors: Tags: Sunday, October 21 Source Type: research
Purpose The purpose of the current project was to explore the feasibility for subtyping dysphagia traits or patterns of scores in a subset of data from the Modified Barium Swallow Impairment Profile global registry in patients referred to videofluoroscopic swallowing studies across 5 common medical categories: (a) cardiothoracic, (b) gastroenterology, (c) head and neck cancer, (d) neurology, and (e) pulmonary.Method Videofluoroscopic swallowing study imaging and Modified Barium Swallow Impairment Profile metrics were used to evaluate 235 patients with dysphagia grouped into 1 of the 5 categories. Two summative domain score...
Source: American Journal of Speech-Language Pathology - Category: Speech-Language Pathology Source Type: research
SLPs came to ASHA’s Health Care Connect conference ready to learn about dysphagia, head and neck cancer, Parkinson’s disease, concussion, delirium—and much more. Across three days of sessions, SLPs heard how their unique skills and training prepared them to work as an integral part of multidisciplinary teams. Editor’s note: This is part two of a series on tips SLPs learned at ASHA Connect 2018. Read part one for insights heard from attendees of the schools’ sessions. Ruth Snyder, an SLP and solo practitioner in Jacksonville, Florida, began her Friday morning at Vivian Sisskin’s session, ...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Academia & Research Events Health Care Private Practice Schools Slider Speech-Language Pathology dementia Dysphagia Parkinson's Speech Disorders Source Type: blogs
ConclusionThe translation and adaptation into Brazilian Portuguese of the Radiotherapy Edema Rating Scale was successfully performed and showed to be easy to apply.ResumoIntroduçãoO linfedema interno é uma das sequelas do tratamento para o câncer de cabeça e pescoço, podendo levar a alterações de grau variado na deglutição, voz e respiração. A Escala do Edema da Radioterapia (Radiotherapy Edema Rating Scale), elaborada por Patterson et al., é uma ferramenta de avaliação do edema de faringe e laringe.ObjetivoTraduzir, par...
Source: Brazilian Journal of Otorhinolaryngology - Category: ENT & OMF Source Type: research
More News: Cancer | Cancer & Oncology | Head and Neck Cancer | Men | Nutrition | Pathology | Speech Therapy | Speech-Language Pathology | Study