JCPSLP Vol 19 No 2 2017

Seventeen respondents (22%) commented that a dedicated position should be part-time: I’m not sure if a position would be needed for full- time basis, unless the SLP was also offering recipes, creating menus for each diet consistency, assisting with ordering products, and other tasks that are currently being completed by food services [staff]. (Participant 109) Another stated, “It is essential to have representation at these meetings, the [full-time equivalent needed] is probably dependent on the size of the network …” (Participant 87). Four participants (5%) suggested that a dedicated role should be temporary, such as for projects or research. For example, Participant 68 commented: “Excellent idea! Even just as a project/temporary role with goals around minimisation of risk/waste etc. and establishing solid procedures/ policies” . Another four participations (5%) did not feel the role would be appropriate to their setting, but commented the role would still have merit perhaps in different settings or contexts. “This work is the last job on the to-do list of a regional, rural or remote speech path, but would make a big difference to patient care” (Participant 7). One of these participants suggested a state-wide position: “I would encourage this as a state-wide position due to consistent and similar issues being tackled locally across the state” (Participant 110). Three respondents (4%) commented that they did not believe a dedicated SLP in food services role would be beneficial. Concerns focused around the role being limited and the potential disadvantage of splitting food services skills from general clinical duties, as one respondent commented: I think it is important to be affiliated with food services and work closely with them so that issues can be easily resolved however I don’t think there needs to be a SLP that is dedicated to this department. (Participant 114) A final open-ended question provided the respondents with an opportunity to add any other comments. A total of 20 respondents provided additional comments. Resultant themes were similar to the previous question. Almost half of the respondents (n = 8, 40%) provided general comments about the nature of the relationship between food services and speech-language pathology departments within respondents’ facilities, or expressed interest in results of the survey: “It is an area which does not always get recognised as a speech-language pathology role by management…” (Participant 74). Six respondents (30%) made comments about the potential benefits of a SLP in food services to the organisation and patient safety. For example, one respondent shared information about the complexity of their health service and the possibilities of a dedicated role in food services: I find that food service in aged care is even more complex than acute services as in order to provide person-centred care, we need to be able to be flexible for those long-term residents. It is limiting for residents if we stick strictly to the national guidelines for meals, and I find in order to provide quality of life in aged care, we are often making exceptions for individuals… This is another example of the complexity of Food Service and how our facilities within each hospital and health

service would benefit from a dedicated food service SLP. (Participant 17) Three respondents noted potential barriers to such a role, with attitudes and competing clinical priorities being of primary concern: “Residential facilities are VERY resistant to anyone other than food service staff making suggestions, particularly dietitians and SLPs. When suggestions are accepted (grudgingly) there is always the complaint that it makes more work for them” (Participant 49). Discussion The present project aimed to explore the prevalence, practices and roles of SLPs working within food services. It also examined the type of tasks related to food services that SLPs take on within their clinical roles, and SLPs’ perspectives on a hypothetical dedicated SLP position in food services. The survey revealed that currently only a small number of SLPs surveyed (less than 8%) have a dedicated SLP role in food services within their organisation, despite the majority of respondents (86%) indicating that a dedicated role would be of benefit. Of the dedicated positions reported, most were described as informal liaison/consultation roles, rather than dedicated roles funded to work a regular, set number of hours in food services. The low prevalence of dedicated SLPs in food services roles is consistent with the paucity of literature about this role. Interestingly, the positive response to a possible food service role in this survey, as well as the existence of groups such as the Queensland Health Speech Pathology Food Services Network, indicates this is a growing but under-researched area of SLP practice. Based on the survey results, responsibilities of dedicated SLP roles in food services included: (a) auditing texture- modified diets and fluids compared to national standards; (b) research and quality improvement activities related to texture-modified foods/fluids; and (c) creating and maintaining links between the SLP and food services departments and resolving any issues affecting both services. This diverse range of tasks represents the broad scope of SLP work in food services, which includes education, research, system-wide improvements, liaison with key stakeholders and working on issues of clinical care. These varied SLP activities are similar to the scope of tasks undertaken by dietitians working within food services in Australia (DAA, 2015). It is also interesting to note that, although the greatest proportion of participants reported working within Queensland (44%), only one of the nine dedicated SLP food services positions were based in Queensland. By comparison, dietitians in Queensland Health often have dedicated roles within food services. Dedicated food services SLP positions as reported by respondents were most often senior or higher grade level, or a mix of senior and base grade. This may be an indication of the complexity of tasks within food services and the knowledge of the organisation required to undertake these duties. Zaga and Sweeney’s (2014) systems-level intervention for improving frequency of provision of correct diet/fluids to patients with dysphagia required significant and timely stakeholder engagement across seven disciplines, and modification of several phases of the meal process (prescribing, preparing, ordering and dispensing). This would reflect the need for a more experienced SLP. The majority (98%) of SLPs without dedicated positions in their department or health service reported undertaking food services tasks within existing clinical roles, with work being absorbed within clinical time.

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JCPSLP Volume 19, Number 2 2017

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