JCPSLP Vol 19 No 2 2017

in the literature but are known to be prevalent, and were considered in the set up of the Saturday clinic to be described. Although the literature review did not yield evidence regarding paediatric community health services running on a weekend, it did highlight themes regarding the importance of offering appointments at times that are suitable for families to attend, and the potential benefits of implementing a Saturday service within an allied health setting. Service background The SLP department discussed in this article offers paediatric outpatient services 8.30am – 5pm, Monday to Friday. Assessment and therapy is offered for speech, language, fluency, voice and paediatric feeding, and clients are generally between 3 and 8 years old. Children eligible for early intervention or alternative public funding are referred to other services. Intake appointments are offered to establish if children are eligible for other services, and to provide parents with some strategies to use while waiting for therapy. Waiting times for therapy range from 8 months to 15 months from referral. Therapy is usually offered on an individual basis, with groups run at times to manage the waiting list. There is a strong focus on home practice, with families encouraged to take responsibility for booking their next appointment when they have completed home practice. In response to growing demands on local paediatric SLP services, the SLP department was contracted by Western Medicare Local (WML), NSW to provide additional services to the community. This contract for $8000 was to enhance access to paediatric SLP services by providing additional staffing and clinic time/availability. Due to the above-mentioned difficulties for families to attend appointments during usual business hours, it was decided to extend the available appointment times to cater to family commitments. Offering appointments after 5pm on weekdays was considered; however, this would not have greatly increased the number of additional therapy appointments available. It was also felt that children and families would find later appointments such as 6pm and 7pm difficult for concentration, attendance, and subsequent therapy gains. Western Medicare Local provides an after-hours medical/ GP service which includes a Saturday service, and private SLP providers do offer Saturday appointments. As such, a Saturday service option for paediatric SLP was developed within the team, in consultation with department managers, WML, and families. Implementation The service The Saturday clinic service was run for two months by three speech-language pathologists who were employed full-time, but volunteered to work the Saturdays as paid overtime. Each clinician worked between five and seven Saturdays in total, and offered from three to seven hours per Saturday shift. Consideration was given to prior weekend commitments and some weekends a clinician was not available. One clinician was only available for a maximum of three hours per Saturday. The clinics did not start until after 10am. In total, 94 hours of service were provided by the three clinicians over two months. These hours are summarised in Table 1.

Table 1. Hours provided by week and by SLP

SLP 1

SLP 2

SLP 3

Week 1

6 hours

6 hours

nil

Week 2

6 hours

6 hours

nil

Week 3

6 hours

nil

3 hours

Week 4

6 hours

6 hours

3 hours

Week 5

6 hours

7 hours

3 hours

Week 6

6 hours

7 hours

3 hours

Week 7

nil

6 hours

2 hours

Week 8

6 hours

nil

nil

Total hours/SLP

42 hours

38 hours

14 hours

The clients The clients offered the Saturday clinic were either current therapy clients who had difficulty attending during the week due to work/school commitments, or were the next clients on the waiting list. Families were offered weekly appointment slots for the duration of the Saturday clinic. Children could not attend the Saturday clinic and the weekday clinic at the same time. Twenty-eight children were offered review and/or therapy appointments on Saturdays, and 20 were able to attend. Eighty-eight sessions were scheduled, with 12 cancelled appointments. Four of these cancelled appointments were missed on a long weekend. Five appointments were cancelled due to illness and were unable to be rescheduled at short notice due to the limited timeframe and availability of the Saturday clinic. Seven of the 20 children were discharged following review and/or therapy. Where children were discharged prior to the completion of the Saturday service, the timeslots were reallocated to additional children who needed to complete a standardised assessment, or who would continue therapy following the conclusion of Saturday sessions. These details are summarised in Table 2.

Table 2. Saturday paediatric SLP service summary

Number of children offered review/therapy appointments on a Saturday:

28

Number able to attend:

20

Occasions of service (OOS) offered:

88

Cancelled appointments (Unable to attend/Failed to attend):

12

Number of children discharged:

7

Evaluation Parent feedback questionnaires were issued at the conclusion of the Saturday clinic, and included a range of custom- designed questions focusing on parent satisfaction with service accessibility, therapy outcomes, and likelihood of attending additional Saturday clinic sessions should the opportunity arise. The results of the questionnaire, in addition to verbal feedback received, indicated that parents were very appreciative of the opportunity to attend Saturday therapy sessions. Many parents expressed an interest in continuing the Saturdays should this be a possibility in the future.

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JCPSLP Volume 19, Number 2 2017

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