The emergency department acts as the first port of call for many individuals with wide-ranging diagnoses and conditions, several of whom may potentially present with dysphagia. It is not a usual environment in which speech and language therapists regularly work, however there is clearly scope for examining whether early dysphagia screening and referral improves patient outcomes. The authors of this paper used an interesting mixed-methods approach called ‘concept mapping’ to identify what changes are required to improve SLT services and dysphagia management in the ED. For their research setting, 53 unique statements were generated from multidisciplinary stakeholders which were grouped into eight clusters: dysphagia management processes for MDT; education and training; communication process and access to information; dysphagia identification and documentation processes; service evaluation and improvement; SLT referrals and services; SLT and MDT collaboration; and staffing and resources. The analysis allowed for the development of a matrix for action with 17 statements falling into the Go/green zone indicating highest changeability and highest importance. The statement “clear documentation by SLT re: recommendations” was rated highest and therefore the best starting point for change. This paper is useful for illustrating a clear methodology to investigate complex systems / services with multiple stakeholders with differing views and how to agree on starting points for actionable change.
Dysphagia services in the emergency department
Reviewed by Roganie Govender
Dysphagia Management in the Emergency Department: Using Concept Mapping to Identify Actionable Change to Improve Services.
CONTRIBUTOR
Roganie Govender
University College London, Head & Neck Academic Centre, UK.
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