[Dysphagia] weekend coverage in acute care

[Nancy.Behrndt at LonestarHealth.com (Behrndt Nancy R)]

We provide coverage 7 days a week, with Sunday being on call for those
patients that require either evaluation or would lose gains if not seen.  We
are a small 180 bed hospital and it is difficult to staff, but we manage.
Realistically, in this day and age, you will more than likely need to at
least rotate one weekend day a month as a  full time speech therapist in an
acute care setting.  Our standard is all patients are assessed within 24
hours of when the order was received.  Hope this helps

Nancy R Behrndt MS-CCC/SLP
Director of Therapy Services
Denton Regional Medical Center
(940) 384-3975


-----Original Message-----
From: Connors, William A. [mailto:connorswa@ph.upmc.edu]
Sent: Tuesday, February 08, 2005 12:30 PM
To: Sally.Gorski@co.hennepin.mn.us
Cc: dysphagia-bounces@b9.com; dysphagia@b9.com; Patti Larghi; Morgan
Jennie (RXP) Speech & Language Therapy
Subject: RE: [Dysphagia] weekend coverage in acute care


The minimum acceptable delay in terms of JCAHO guidelines appears to be 24
hours.
 
-----Original Message-----
From: Sally.Gorski@co.hennepin.mn.us [mailto:Sally.Gorski@co.hennepin.mn.us]
Sent: Tuesday, February 08, 2005 12:41 PM
To: Connors, William A.
Cc: dysphagia@b9.com; dysphagia-bounces@b9.com; Morgan Jennie (RXP) Speech &
Language Therapy; Patti Larghi
Subject: RE: [Dysphagia] weekend coverage in acute care
 

We were just involved in a JCAHO mock survey last week and this topic came
up.  The point made was that patients should receive equal service in your
facility no matter what day they enter the doors.  At this point we provide
Saturday coverage (usually morning) to see dysphagia patients, new consults,
f/u's, etc. but if a consult comes in late in the day Saturday, we are most
likely gone so that patient waits until Monday morning.  Same with the
Sunday consults. We have to change our practice and provide Sunday coverage
was the message from the surveyor. 

Sally Gorski 
Hennepin County Medical Center 
Minneapolis, MN 



"Connors, William A." <connorswa@ph.upmc.edu> 
Sent by: dysphagia-bounces@b9.com 
02/08/2005 11:06 AM 

To
"Morgan Jennie \(RXP\) Speech & Language Therapy"
<Jennie.Morgan@cddah.nhs.uk>, "Patti Larghi" <plarghi@msn.com>,
<dysphagia@b9.com> 

cc
 

Subject
RE: [Dysphagia] weekend coverage in acute care
 

 
 



Interesting approach - just stick an NG tube in 'em.  I guess that's OK as
long as it's not my mother who is doing the waiting or is receiving the
uncomfortable NG tube unnecessarily.   This seems quite a bit like
inequitable discrimination and providing different levels of care to
patients of similar levels and diagnoses which violates, in the U.S., acute
care JCAHO regulations.   What say you all?

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On Behalf Of
Morgan Jennie (RXP) Speech & Language Therapy
Sent: Tuesday, January 25, 2005 10:07 AM
To: Patti Larghi; dysphagia@b9.com
Subject: RE: [Dysphagia] weekend coverage in acute care

It sounds like your patients get reasonable treatment only waiting up to 24
hours. Working in the NHS in Britian most hospitals do not have SLT cover
for weekends. If a patient is referred late on a Friday afternoon then they
have to wait until Monday morning before they are seen, which means that
they are NBM for the whole time.
Obviously this is far from ideal but we are not willing to lose our
Monday-Friday working practice. If a doctor is concerned about nutrition and
hydration then they often pass an NG tube until the patient can be assessed
by our department.

Jennie Morgan
Speech and Language Therapist
Durham

________________________________

From: dysphagia-bounces@b9.com on behalf of Patti Larghi
Sent: Tue 25/01/2005 14:53
To: dysphagia@b9.com
Subject: [Dysphagia] weekend coverage in acute care



I am hoping to get some feed back from those of you that work in an acute
care setting. More specifically smaller hospitals that don't have regular
weekend coverage.  Firstly, we are trying to establish a protocal for
nursing to use as a screening tool to establish a need for an order for a
swallow eval.
The second part of the problem is covering the swallow evals once they are
written. Currently we use an on-call program. The SLP has 24 hours to
respond. The problem is of course those patients that enter the hospital on
Friday p.m. and the physician writes on order for patient to be NPO until
evaluated by SLP. If our on-call therapist can not make it until Sat. p.m.
we feel this is an excessive length of time for the patient to wait  but at
this point we are in a dilema at to how to solve this issue.
Our nursing director suggested that the patinet receive a dysphagia diet
(Pureed honey thick liquids) until the eval and that the nurse be provided
with a screening tool to assure diet tolerance.
Anyway I would appreciate some feed back from those of you working in
simliar settings as to what your hospitals are currently doing to keep
patient safe and to provide nutrition in a timely manner.

Thanks, Patti Larghi


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