ACQ Vol 10 No 2 2008

Work– l i f e balance : preserv i ng your soul

Wendy M. Archer (B.Sp.Path.) is a senior speech path­ ologist at the John Hunter Hospital in Newcastle, New South Wales. Dr Anne E. Vertigan (B.App.Sc.(SpPath); MBA; PhD) is the area director for speech pathology in Hunter New England Health, New South Wales. I am grateful for the encouragement and data collection conducted by Kate Griffin (former senior speech pathologist at the John Hunter Hospital). Conclusion This retrospective database audit demonstrates high utilisation of the weekend speech pathology service supporting its long- term need to continue. Increasing the evidence base to support weekend services may benchmark speech pathology as a seven-day profession in acute care. References Chan, D., Phoon, S., & Yeoh, E. (2004). Australian society for geriatric medicine position statement No. 12: Dysphagia and aspiration in older people. Australasian Journal on Ageing , 23 (4), 198–202. ECRI, Plymouth Meeting. (1999). Diagnosis and treatment of swallowing disorders (dysphagia) in acute-care stroke patients. In J.M. Eisenberg & D.B. Kamerow (Eds.), AHRQ Evidence reports & summaries (No. 8). Rockville, MD: US Department of Health & Human Services. Hunter New England Health. 2005. John Hunter Hospital, Newcastle, New South Wales 11 March 2008, retrieved http:// intranet.hne.health.nsw.gov.au/services_and_facilities/john_ hunter_hospital/. Tomolo, G. (2006). “Skip the Sunday roast, I’m at work!” The speech pathologyweekend service at the Royal Melbourne Hospital. Acquiring Knowledge in Speech, Language and Hearing , 8 , 28–31. Acknowledgments

upgrades over the weekend while without a speech path­ ology service they would be required to wait for weekday review to progress. Anecdotally there is the perception among the medical staff that providing a weekend service minimises hydration and/or nutritional complications, as a consequence of their nil by mouth status. This early intervention enables medication to be administered orally or via nasogastric tube, which contributes to stabilising or improving patient medical status. This approach poses potential for improved medical outcomes, thereby reducing length of hospitalisation. Models of weekend service delivery Although both JHH and RMH provide a 4-hour service on Saturday and Sunday, there appear to be some differences in the weekend service delivery models between the JHH and the RMH programs. The first difference relates to staffing. RMH recruit weekend speech pathologists with a minimum of six months acute experience. In contrast JHH has not been able to routinely recruit speech pathologists with experience and has employed new graduate speech pathologists with senior supportive phone contact. With JHH located in regional NSW it is not always possible to attract speech pathologists to the area with postgraduate experience. The second difference relates to the caseload served. Laryngectomy and tracheostomy caseloads are serviced at RMH on weekends. In contrast these caseloads are not serviced on weekends at JHH due to difficulty recruiting speech pathologists with training in these specialised areas. Despite these differences it appears that both the JHH and RMH models offer a successful weekend speech pathology service. Future directions Future studies could focus on the impact of weekend service speech pathology on length of hospitalisation, and measure other factors such as patient and carer/family views as recipients of weekend services. Further data analysis could examine the number of low priority patients recommended for weekend review who were held over to Monday due to time constraints. Anecdotal evidence suggesting reduced workload stress among our department speech pathologists as a consequence of the weekend service could be formally assessed.

Correspondence to: Wendy Archer Speech Pathology Department

John Hunter Hospital, Locked Bag No. 1 Hunter Region Mail Centre, NSW 2310 phone: 02 4921 3721 email: wendy.archer@hnehealth.nsw.gov.au

Appendix A.Weekend speech pathology service referral Date: ________________ COMPLETED BY THE PATIENT’S USUAL SPEECH PATHOLOGIST: The patient’s database must be attached to this referral, with the patient admitted onto AHMIS prior to referral where possible. Place in the weekend folder by 4 p.m. on Friday.

Patient Name: Ward: Case Load: Medical Diagnosis: Speech Pathology diagnosis/diagnoses

1 2

. .

3.

Patient’s current diet: Date of most recent contact:

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ACQ uiring knowledge in speech , language and hearing , Volume 10, Number 2 2008