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[Dysphagia] FYI: Neuro exam infants andchildrenvideopresentations online



The decision was made for us regarding Sunday coverage (we have been 
providing Saturday coverage for new consults for years).  JCAHO's mandate 
regarding "one level of care" was the driving force behind the decision to 
add Sunday coverage.  That is, a patient entering the hospital on a 
Saturday afternoon (for example)  should expect and receive the same level 
of care that other patients receive Mon-Fri.  Our Neurology team also 
consults speech path on almost every patient on their service so it just 
made sense to add Sunday coverage even though we (the speech path staff) 
have been resisting this idea for years.   For many years our PT 
colleagues have provided 7 day/week including Holiday coverage and our OT 
colleagues added Sunday coverage a couple of years ago.  We're a Level One 
trauma center, teaching hospital, acute rehab, etc.  The change to Sat/Sun 
coverage not only impacted our dept, but also departments such as EEG, 
Cardiac Rehab, EMG, etc.  These are all services that the patient would 
typically have to wait until Monday morning if they were admitted anywhere 
between late Fri afternoon and Mon morning.  It's a sign of the times I 
think especially in large metropolitan facilities.  However, at this 
point, we are not coming in on the six major holidays - so we aren't here 
365 days ------- yet! 

Staffing Sundays is a challenge and I won't get into it in this post. 






"Thompson, Elana" <EThompson@mountnittany.org> 
Sent by: dysphagia-bounces@b9.com
08/10/2006 09:47 AM

To
"Irene Campbell-Taylor" <eripley@yahoo.com>, "Erin Powazek" 
<epowazek@hotmail.com>, <jsaunt@hotmail.com>, <dysphagia@b9.com>
cc

Subject
RE: [Dysphagia] FYI: Neuro exam infants andchildrenvideopresentations 
online






I was hoping to get that response from Irene since I have read it before. 
 
I guess that is why I was wondering why the doctors at that subscriber's 
workplace would automatically make a patient NPO or put him/her on the 
puree/honey diet just because an SLP is not there for the weekend.  It 
doesn't make sense that those would be the only two solutions to having no 
weekend coverage.  It seems to me to be a disservice to the patient. 
 
We have no weekend coverage, per say, at the acute care facility in which 
I work and the doctors will either keep a person NPO if that is called for 
or will start a diet like clear liquids or even soft regular and then will 
have the SLP eval on Monday.  We do not have an increased number of 
pneumonias or deaths by not using thickeners and puree as some sort of 
false safety net.

________________________________

From: Irene Campbell-Taylor [mailto:eripley@yahoo.com]
Sent: Thu 8/10/2006 8:34 AM
To: Thompson, Elana; Erin Powazek; jsaunt@hotmail.com; dysphagia@b9.com
Subject: RE: [Dysphagia] FYI: Neuro exam infants 
andchildrenvideopresentations online




"Thompson, Elana" <EThompson@mountnittany.org> wrote: 

                 What makes a puree diet with honey-thickened liquids 
safe?
 
                 *** Who says that it is "safe"?  What evidence is there?

                 Is there evidenced-based data that that is a clinically 
safer diet?
 
                 *** There are no evidence-based data in oropharyngeal 
dysphagia.
 
 



Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com

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