JCPSLP Vol 19 No 2 2017

to New Zealand. The lack of prior research in the area further impacted the questions generated for the survey, as they were based on local and anecdotal knowledge as opposed to previous, substantive research in the area. The use of a survey as the only data collection medium was also a limitation, as interviewing the participants to clarify questions and explore themes further was not undertaken, and may have yielded greater contextual clarity and understanding of the nexus between speech-language The present findings warrant further research into the current practices and duties of SLPs in relation to food services. Specifically, examination of SLP time spent on food services tasks within existing clinical roles and investigation of the impact of SLP input into food services in terms of patient satisfaction and safety would be warranted. Barriers and facilitators to SLP work within food services should also be investigated, from the perspectives of both SLPs and food services workers. Based on the current findings, SLP services and managers may also wish to consider evaluating the time that clinicians spend in food services tasks and potentially trial a dedicated SLP role in food services, or the allocation of dedicated time for SLP involvement in food services tasks. Exploration of the impact of SLP input into food services with regards to patient outcomes, quality of services and budgetary concerns should also be considered. Conclusion The survey, though preliminary, provides insight into the current practices of SLPs in food services and potential areas for further more formalised research in this area. Although the majority of SLPs undertake food services related tasks within existing clinical roles, few organisations have dedicated food services SLP roles. The majority of SLPs see a dedicated food services SLP role as a potentially useful position which may have a positive effect on communication and understanding between SLP and food services and, ultimately, patient safety. However, empirical investigation of the SLP role in food services is needed before any conclusions regarding their impact can be made. Declarations of conflicting interests The authors declare that they have no conflict of interest. References Altman, K. W., Yu, G. P., & Schaefer, S. D. (2010). Consequence of dysphagia in the hospitalized patient: impact on prognosis and hospital resources. Archives of Otolaryngology-Head & Neck Surgery , 136 (8), 784–789. Australian Government Department of Health. (1994). Rural, remote and metropolitan areas (RRMA) classification. Retrieved from Australian Institute of Health and Welfare, http://www.aihw.gov.au Bethlehem, J., & Biffignandi, S. (2011). Handbook of web surveys (Vol. 567). Hoboken, NJ: John Wiley & Sons. Bourdel-Marchasson, I. (2010). How to improve nutritional support in geriatric institutions. Journal of the American Medical Directors Association , 11 (1), 13–20. Broz, C. C. (2009). Healthcare foodservice workers’ knowledge of dysphagia and development of a sensory descriptor lexicon and benchmarking instrument in pathology and food services. Recommendations

Several respondents made comments about the competing priorities of food services work, patient contact and other responsibilities. While the majority of SLPs perceive work in food services as valuable, absorbing these extra food services duties into existing clinical roles may place additional pressure on systems which are often already at capacity. Heavy, underresourced workloads are reported by SLPs in the literature (McLaughlin, Lincoln & Adamson, 2008) and time constraints were identified in this survey as a barrier to undertaking food services tasks. These issues may account, in part, for the lack of formal SLP roles in food services to date. Generally, most respondents were in favour of dedicated food services SLP positions and believed there would be benefits to patient safety and quality of care. This is consistent with previous research of SLPs collaborating with food services and the multidisciplinary team, resulting in a reduction of incorrect dietary items being delivered to patients (Zaga & Sweeney, 2014). The impact of SLP work in food services has not been evaluated thus far; however, dietitians working as food services managers have reported that their allied health training supports the integration of food services with the clinical management of patients (Kuhn, 2014). Although few facilities within this survey had dedicated food services SLPs, participants reported food services meetings primarily included dietitians, food services managers and SLPs. SLP presence at food services meetings indicates that engagement and collaboration between SLPs and food services occurs, even in the absence of a dedicated food services SLP position. This may indicate the importance of SLP involvement in food services processes, and SLPs’ interest in food services. Indeed, SLPs have been mentioned as “champions” for effective change in food services practices A significant limitation of this study was the lack of clear definition of the term “dedicated”. Authors used the term to indicate a speech pathology role with time or funding specifically allocated to food services; however, this was not made explicit in the survey. From subsequent comments and responses to open-ended questions, it was apparent most respondents interpreted the term “dedicated” accurately. Inclusion of a “pop-up” definition for key terms would address this issue in future surveys. Another limitation of this study was the relatively low response rate, which was perhaps related to the medium of distribution (email). Although online surveys are fast, simple and cost-effective (Bethlehem, & Biffignandi, 2011), an inherent issue is the response rate, which is often low (Sheehan, 2001). The addition of a follow-up contact may have improved the response rate as would perhaps increasing the length of time the survey was “live”. Although the response rate was low, the spread of respondents over six states and one territory in Australia permitted a sample of the current state of SLP views and practices related to SLP food services roles to be considered. However, results should be interpreted with caution as the majority of responses were from one state (Queensland) and most participants were located in metropolitan settings. There were also multiple respondents from the same facility or health service, which may have influenced the findings for some questions. Although a number of facilities were invited to participate in New Zealand, the response rate was very low (3%), limiting the applicability of these findings (Jukes et al., 2012). Limitations

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JCPSLP Volume 19, Number 2 2017

Journal of Clinical Practice in Speech-Language Pathology