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www.speechpathologyaustralia.org.au
JCPSLP
Volume 19, Number 2 2017
63
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.