[Dysphagia] Qualifications: Consider Dysphagia Teams

[Wilma.Clancy at cdha.nshealth.ca (Wilma Clancy)]

I find this discussion very interesting.  What is abundantly clear to me
is that very few of you work in teams.  I don't mean teams that you only
see on paper, but actual practitioners that do assessments and make
decisions and make care plans cooperatively together.  I work in a
Canadian tertiary acute care facility where the speech language
pathologist and the dietitian work together--side by side.  Our
training, skill sets and knowledge base are very complimentary and work
together in the best interest of the patient.  Where the SLP has a more
vast knowledge regarding the neuro assessment, the dietitian has a
better grasp on the medical condition of the patient.  We do both the
clinical bedside assessments together and the modified barium swallow
assessments together.  I'm sure many of you think this isn't
cost-effective.  However, we find it very efficient, as we can "divide
and conquer" the tasks at hand,  including:  charting, family education,
staff education, diet orders, tube feed changes, posting feeding
guidelines at bedside, etc.  The dietitian monitors medical, nutritional
and hydration status carefully, while the SLP monitors neurological and
respiratory change and together we alter the care plan and reassess
dysphagia to provide patient-centred care.  We can't be expected to know
it all and do it all, and it's very important to know where your
expertise lies and to know what you don't know. We all try to keep up
with the dysphagia literature, and even here find complimentary skills
when looking at the literature and weighing the evidence.  Dysphagia
teams work, and who better to be on them than the SLP and
dietitian--especially in acute care.  

Respectfully submitted,
Wilma Clancy P.Dt.  Clinical Dietitian Stroke and Neurology

*****************************************
Confidentiality: This email message may contain confidential
information and is intended only for the individual named. If you
are not the named addressee you should not disseminate, distribute
or copy this email. Please notify the sender immediately by email
if you have received this email by mistake and delete this email
from your system. Email transmissions cannot be guaranteed to be
secure or error free as information could be intercepted, corrupted, 
lost, destroyed, arrive late or incomplete, or contain viruses. 
The sender therefore does not accept any liability for errors or
omissions in the contents of this message that arise as a result 
of email transmissions. If verification is required please request a hard 
copy version.