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Shaping innovative services: Reflecting on current and future practice
72
JCPSLP
Volume 19, Number 2 2017
Journal of Clinical Practice in Speech-Language Pathology
Emily Davis (top),
Jessica Bauer
(centre) and
Katrina Rohr
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
KEYWORDS
FUNDING
PAEDIATRIC
SATURDAY
SERVICE
Paediatric speech language pathology (SLP)
in the community health setting is historically
provided Monday to Friday during usual
business hours. While weekend acute
services have previously been implemented
for speech-language pathology at various
hospitals, there is no evidence in the
literature regarding weekend paediatric
community health services. A Saturday
service for community health SLP was
implemented for two months, and was made
possible as a result of additional funding
provided by Western Medicare Local, NSW.
Outcomes were measured by parental survey,
occasions of service, number of discharges
and staff report. This article presents a
detailed overview of the service delivery
model, considerations for implementation,
and reflections on the benefits and
challenges of providing a paediatric Saturday
service.
T
he recent Senate Inquiry into Speech Pathology
(Commonwealth of Australia, 2014) highlighted
a number of issues affecting the availability and
uptake of speech-language pathology services. These
factors included the increasing demand for speech-
language pathology services, lengthy waiting lists, restricted
service delivery models, large caseloads, lack of time
and resources, and geographical diversity. Although
these issues are well recognised by speech-language
pathologists, solutions are not necessarily apparent, nor
able to be implemented without access to additional
resources.
Ruggero, McCabe, Ballard, and Munro (2014) conducted
a survey of 154 parents from across Australia. They
established that parental satisfaction with a service was
impacted by the length of time they waited for a service,
the frequency of access to that service, the type of
service provided, and the perceived support or follow-up
received during “down” times. A significant majority of the
participants (89%) in Ruggero et al’s. (2014) study, rated
availability of local services as “unavailable” or “insufficient”,
and identified the needs for more services, shorter waiting
times, greater affordability and more flexibility in service
delivery, as desired solutions for this issue. Interestingly,
the service delivery models discussed in the Ruggero et al.
(2014) article included varied appointment frequency (e.g.,
weekly, monthly, yearly), and individual/group therapy, but
not services outside of usual business hours.
McAllister, McCormack, McLeod, and Harrison (2011)
further emphasised the importance of listening to and
responding to client and family preferences, finding
that in order for families to feel able to access speech
pathology services regularly and consistently, the service
must be offered at a time that is appropriate for the family
to attend. Appointments need to be scheduled with
consideration of parent/caregiver commitments (including
work) and children’s commitments including school and
extra-curricular activities. This reflection arose from the
observation that after work/school appointments were
extremely popular with the clients of the SLP service
showcased, and were often booked out weeks in advance.
In light of these findings, and cognisant of the paucity of
published literature about non-traditional paediatric speech-
language pathology service delivery, a literature review
was conducted to establish if other services or disciplines
had published information regarding weekend services,
and the impact these services had on client outcomes.
The literature was primarily accessed through CIAP, with
search terms including “Saturday”, “weekend”, “after
hours”, “allied health”, and “service delivery”. The review
yielded several articles that discussed Saturday services
in the inpatient/ rehabilitation setting, with particular
reference to physiotherapy and occupational therapy
(Brusco, Watts, Shields, & Taylor, 2014; Hakkennes, Linder
& Reid, 2015; Peiris, Taylor, & Shields, 2012; Taylor et al.,
2010). These articles discussed the benefits of a Saturday
service, including reduced length of stay and improved
client outcomes for therapy given in addition to weekday
rehabilitation. However, the literature search did not reveal
any published data for any allied health services specifically
pertaining to community health or paediatric allied health
clinics running on a Saturday.
Currently, SLP services are offered on Saturdays in
some major hospitals. Other services do not offer a
regular Saturday inpatient service, but may offer inpatient
SLP cover for a long weekend (e.g., four hours on the
third day). This service provision is for acute care and in
particular clients with stroke and dysphagia. Models of
service delivery in the private sector were not discussed
Saturday paediatric
speech-language
pathology service
Emily Davis, Jessica Bauer and Katrina Rohr