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ACQuiring knowledge in speech , language and hearing, Volume 10, Number 2 2008 53
Work– l i f e balance : preserv i ng your soul
upgrades over the weekend while without a speech path­
ology service they would be required to wait for weekday
review to progress. Anecdotally there is the perception
among the medical staff that providing a weekend service
minimises hydration and/or nutritional complications, as a
consequence of their nil by mouth status. This early
intervention enables medication to be administered orally or
via nasogastric tube, which contributes to stabilising or
improving patient medical status. This approach poses
potential for improved medical outcomes, thereby reducing
length of hospitalisation.
Models of weekend service delivery
Although both JHH and RMH provide a 4-hour service on
Saturday and Sunday, there appear to be some differences in
the weekend service delivery models between the JHH and
the RMH programs. The first difference relates to staffing.
RMH recruit weekend speech pathologists with a minimum
of six months acute experience. In contrast JHH has not been
able to routinely recruit speech pathologists with experience
and has employed new graduate speech pathologists with
senior supportive phone contact. With JHH located in
regional NSW it is not always possible to attract speech
pathologists to the area with postgraduate experience.
The second difference relates to the caseload served.
Laryngectomy and tracheostomy caseloads are serviced at
RMH on weekends. In contrast these caseloads are not
serviced on weekends at JHH due to difficulty recruiting
speech pathologists with training in these specialised areas.
Despite these differences it appears that both the JHH
and RMH models offer a successful weekend speech
pathology service.
Future directions
Future studies could focus on the impact of weekend
service speech pathology on length of hospitalisation, and
measure other factors such as patient and carer/family views
as recipients of weekend services. Further data analysis could
examine the number of low priority patients recommended
for weekend review who were held over to Monday due to
time constraints. Anecdotal evidence suggesting reduced
workload stress among our department speech pathologists
as a consequence of the weekend service could be formally
assessed.
Wendy M. Archer (B.Sp.Path.) is a senior speech path­
ologist at the John Hunter Hospital in Newcastle, New
South Wales. Dr Anne E. Vertigan .(SpPath);
MBA; PhD) is the area director for speech pathology in
Hunter New England Health, New South Wales.
Correspondence to:
Wendy Archer
Speech Pathology Department
John Hunter Hospital, Locked Bag No. 1
Hunter Region Mail Centre, NSW 2310
phone: 02 4921 3721
email:
Conclusion
This retrospective database audit demonstrates high utilisation
of the weekend speech pathology service supporting its long-
term need to continue. Increasing the evidence base to support
weekend services may benchmark speech pathology as a
seven-day profession in acute care.
References
Chan, D., Phoon, S., & Yeoh, E. (2004). Australian society for
geriatric medicine position statement No. 12: Dysphagia and
aspiration in older people. Australasian Journal on Ageing, 23
(4), 198–202.
ECRI, Plymouth Meeting. (1999). Diagnosis and treatment
of swallowing disorders (dysphagia) in acute-care stroke
patients. In J.M. Eisenberg & D.B. Kamerow (Eds.), AHRQ
Evidence reports & summaries (No. 8). Rockville, MD: US
Department of Health & Human Services.
Hunter New England Health. 2005. John Hunter Hospital,
Newcastle, New South Wales 11 March 2008, retrieved http://
hunter_hospital/.
Tomolo, G. (2006). “Skip the Sunday roast, I’m at work!” The
speech pathologyweekend service at the Royal Melbourne
Hospital. Acquiring Knowledge in Speech, Language and Hearing,
8, 28–31.
Acknowledgments
I am grateful for the encouragement and data collection
conducted by Kate Griffin (former senior speech pathologist
at the John Hunter Hospital).
Patient Name:
Ward:
Case Load:
Medical Diagnosis:
Speech Pathology diagnosis/diagnoses 1 .
2 .
3.
Patient’s current diet:
Date of most recent contact:
Appendix A.Weekend speech pathology service referral
Date: ________________
COMPLETED BY THE PATIENT’S USUAL SPEECH PATHOLOGIST:
The patient’s database must be attached to this referral, with the patient admitted onto AHMIS prior to referral where possible.
Place in the weekend folder by 4 p.m. on Friday.