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ACQ
Volume 12, Number 3 2010
ACQ
uiring knowledge in speech, language and hearing
Quality assurance
Katherine
Osborne
McDermott, Hollands, Copley, & Davidson 2004). For
example, Donaldson and colleagues conducted interviews
with parents and their child’s therapists (including speech
pathologists and occupational therapists) regarding their
report writing. They found that while the clinicians felt
they were writing reports that met the parents’ needs, a
mismatch existed between the clinicians’ intentions and
actual practice.
There are few studies concerning parent satisfaction with
speech therapy services in the private sector. However,
one such study was conducted by Mirabito and Armstrong
(2005). They interviewed seven Australian mothers attending
private therapy with their children aged 3 to 7 years. These
researchers found overall responses were positive though
participants had all volunteered to participate in the study.
They suggested that the involvement and motivation of
these mothers may have been exceptional, possibly leading
to results that could not be considered representative.
Nevertheless, all parents reported feeling the experience was
collaborative though they regarded themselves as observers
in the sessions and coaches beyond the clinic setting. Time
limitations and child behaviour were identified as barriers to
involvement.
Hammond (2008) conducted an extensive review of both
quantitative and qualitative studies of client satisfaction with
speech and language services. These studies concerned
both specific services such as aphasia therapy and general
satisfaction with speech and language services. Hammond’s
review of the qualitative research suggested some client
dissatisfaction with regard to the length of therapy, discharge
protocols, client–clinician interaction, activity choice, task
appropriateness, clinician behaviours, functionality of tasks,
explanation of therapy, likely outcomes, and goal choices.
The current quality assurance study sought the opinions of
mothers regarding many of the aspects of service identified
as sources of client dissatisfaction in Hammond’s study as
well as satisfaction with assessment process, reporting, fee
schedule and health rebates. Quantitative and qualitative
data collection in the form of open-ended questions
was used. Open-ended questions allow more detailed
information to be collected and used to improve a practice
(Liamputtong & Ezzy, 2005).
Method
Survey items and format were developed following perusal of
the ASHA Consumer Satisfaction Survey (ASHA, 1989),
Frattali’s 1991 paper discussing the merits of both
This paper reports an attempt at conducting a
quality assurance survey in a private practice
pathology practice. The mothers of 33 children
receiving speech pathology services were
surveyed. The purpose of the survey was to
improve the service provided. A 44-item
survey covering 11 topics was given to
parents, who returned the surveys
anonymously. Results indicated high levels of
satisfaction in relation to the quality of service
provided and validated parent involvement in
assessment and treatment. Findings also
revealed the need for explicit discussion
regarding anticipated length of time in therapy,
for increased teacher consultation and for
cancellation policies to be made explicit.
Finally, some of the difficulties implementing
this quality assurance project are presented.
Q
uality assurance could be defined as the steps
taken to evaluate a service to ensure the service
is of a sufficiently high quality to meet industry
standards. Quality assurance can be achieved through
interaction between the consumer and the supplier.
Involving consumers in evaluating the service promotes
empowerment, ownership, and accountability (Nilson,
Myrhaug, Johansen, Oliver, & Oxman, 2006). Parents, as
consumers, can be used as a significant resource for change
(Andrew, Andrews, & Shearer, 1989)
Is there a need to engage in quality assurance in private
practice? After all, it is reasonable to assume that when
consumers pay for a private service, they are satisfied with
it. Is satisfaction a sufficient goal? Determining whether a
service is satisfactory is important but determining
how
satisfactory a service is, is quite different. Conducting quality
assurance checks could improve a service from mediocre
or merely satisfactory to excellent (Grela & Illerbrun, 1998;
Hammond, 2008).
Client and clinician service evaluation data are necessary
for the provision of satisfying and appealing services
(Hammond, 2008; Nelson & Steele, 2006). Without
feedback from consumers, a mismatch between therapists’
intentions and actual service may exist (Donaldson,
Quality assurance
A private practice perspective
Katherine Osborne
Keywords
CHILD
ASSESSMENT
AND THERAPY
PARENT SURVEY
PRIVATE SPEECH
PATHOLOGY
QUALITY
ASSURANCE