Introduction
In response to the pandemic and following the success of the RCSLT telehealth guidance, there was an increased need to provide clinicians with guidance to facilitate safe and competent remote clinical support to patients in own homes and residential care settings with disorders of swallow.
Therefore, a small group of RCSLT members have developed a telehealth dysphagia assessment decision making tool which is based on this supporting flowchart (PDF).
This tool is a simple ‘yes’ or ‘no’ decision tree with associated help and guidance for therapists considering a remote dysphagia assessment for patients.
It aims to support remote dysphagia assessments by ensuring speech and language therapists (SLTs) are equipped to make the most appropriate and timely decisions, by using best practice standards and enabling the mitigating of clinical risk wherever possible.
It supports an already validated and evidence-based process for telehealth dysphagia assessments conducted remotely by a trained clinician.
We would like to acknowledge Speech Pathology Australia (SPA) and thank them for their permission in using their webisodes from SPA’s Learning Hub as linked throughout the tool.
Key points to consider
The tool helps to ensure clinicians who have achieved competencies at level 5 or above according to the Eating, Drinking and Swallowing Competency Framework (2020) are equipped to make the most appropriate and timely decisions by providing:
- A flowchart to support the decision to do a telehealth dysphagia assessment
- Resources to ensure that this is done safely and that the patient, assistant and clinician are prepared.
- Resources for preparing and conducting a telehealth dysphagia assessment.
- A troubleshooting guide with considerations for risk assessment before, during and after a remote dysphagia assessment.
To enable the mitigating of clinical risk, the tool uses best practice standards with reference to:
- The evidence base for telehealth dysphagia assessments
- Eating, Drinking and Swallowing Competency Framework (2020); and
- RCSLT PPE Guidance (2020)
This tool has been developed by registered SLTs across a variety of clinical areas who are conducting telehealth dysphagia assessments.
Contributors
- stroke service
- acute inpatient service
- community service
- care homes
- progressive neurological conditions
- head and neck cancer
- learning disabilities; and
- older adult mental health.
With special thanks also to Veronica Southern and Liz Boaden for their support and feedback.
