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JCPSLP
Volume 19, Number 2 2017
Journal of Clinical Practice in Speech-Language Pathology
the authors to be a realistic possibility if suitable for both
employer and employee.
It was important to manage client expectations regarding
the continuity of the clinic. It was difficult to book new
clients into the clinic when other children were discharged.
This was related in particular to the finite time period that
the clinic would be provided, and unlikely to be an issue if
offering a continuing service. If the clinic was an ongoing
service delivery option, this issue would have been managed
different and perhaps more successfully navigated.
Scheduling appointments for children around other family
commitments such as Saturday sport was difficult, with
some families requiring times to be variable from week
to week. Other families were not able to attend due to
Saturday sport or other family commitments and expressed
disappointment at this. Had the clinic run at a different
time of year these clients would potentially have been able
to attend on the Saturday. Attendance on the Saturday of
the long weekend was poor, with four out of seven clients
failing to attend. Although parents had been reminded the
previous week that the clinic would continue, in retrospect
a phone or text reminder could also have been provided the
day before to remind families to attend.
Reflection
The Saturday clinic was an innovative model to trial for SLP
in a community health setting, albeit not a new service
delivery concept. Set up and implementation of the clinic
was not deemed challenging for this program, but funding
was, and is, an important consideration if the clinic were to
become a permanent service offering. Anecdotal evidence
indicated that therapy offered on a Saturday was perceived
as beneficial by the children and families who participated,
and children were often observed to be less tired than at
after-school appointments. It also allowed children who
were unable to attend appointments during the week to
receive a service, and is considered a potentially viable
alternative option, particularly for school-aged children.
Parents were very appreciative of the flexibility of service
arrangements with many indicating to staff they would have
liked the Saturdays to continue. With adequate measures in
place, there were no significant security or administrative
difficulties.
This article has discussed a number of considerations for
implementing a Saturday service on a short-term basis, and
there would be additional considerations if implementing
this service on a longer term or permanent basis. Staff and
parents were overall very positive about the experience,
and children made positive gains towards their therapy
goals. It is not the intention of this article to suggest that
Saturday services should be a permanent addition to
community health service provision. However, a Saturday
clinic could be explored as an option to utilise vacant full
time equivalent positions on a short-term basis, or explored
as part of flexible working arrangements, particularly for
clinicians returning from parental leave.
References
Brusco, N. K., Watts, J. J., Shields, N., & Taylor, N. F.
(2014). Are weekend inpatient rehabilitation services value
for money? An economic evaluation alongside a
randomized controlled trial with a 30 day follow up.
BMC
Medicine
,
12
(1), 1–11. doi:10.1186/1741-7015-12-89
Commonwealth of Australia (2014).
Senate Community
Affairs References Committee: Prevalence of different types
Some parents of children who were offered a Saturday
appointment but declined due to conflicting commitments,
expressed disappointment that they were not able to take
on the opportunity at the time it was available.
The children participating in Saturday clinic made
many positive speech and language gains. A number of
children were discharged at the end of the Saturday clinic
as they had achieved their goals. It is uncertain if goals
were achieved more quickly compared to usual weekly
therapy. However, it would be reasonable to expect that
significant difference in client outcomes would not be
noted, as flexibility of service models addresses a need and
preference identified by parents; an outcome aligned more
with service satisfaction rather than improved therapeutic
outcomes. However, this is an important issue to consider
and may warrant further evaluation. Some school-aged
children who had previously been offered therapy, but
had difficulty attending during the week, were offered six
sessions and were then discharged.
In regards to attendance, 13.6% of appointments were
cancelled (either failed to attend or unable to attend). This
compared to a weekday clinic rate of 25.1% cancelled
appointments (any reason) for the same period, suggesting
that families were motivated to attend on a weekend
where their schedules and commitments had been
accommodated.
Important issues to consider
Security and safety were considered prior to and during the
implementation of the clinic. The area was within a hospital,
and accessible by swipe card only. Staff required
amendments to their swipe card access to enter the
department on a Saturday. Security staff were notified of
the clinic. All staff had personal duress alarms for additional
security, due to isolation of clinic rooms and reduced staff
presence on Saturday. There were also duress alarms in
two out of three of the clinic rooms, and telephones in all
rooms. There was no administration support on the
Saturdays, although other groups such as ante-natal
classes were using the department.
The SLPs involved volunteered to work paid overtime.
The Human Resource Department was consulted regarding
the implementation of overtime. From the NSW State
Award, the first two hours of overtime was paid at time-
and-a-half, and time thereafter was paid at double time.
It was agreed that overtime was suitable for a short and
specific duration, but was not to be implemented on an
ongoing basis. Staff reported increased efficiency on the
Saturdays as there were no phone calls (except some
cancellations), no emails, and minimal interruptions.
Challenges
Staff reported fatigue at the end of the clinic and agreed
that it would not be possible to conduct the clinic
indefinitely in its current form of overtime. The overtime was
a reasonable service innovation for a short and specified
duration; however, it would not be sustainable. Having
Saturdays as a usual work day (for example, instead of
Monday), or for part-time staff (for example, working
Thursday, Friday and Saturday) was considered viable by all
SLPs participating, but would have required greater
adjustment of services than was available in this pilot
evaluation. In an environment where work–life balance is a
consideration for the employer, and returning part-time from
maternity leave a common occurrence in the profession,
working Saturdays as a usual work day is considered by