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[Dysphagia] Dysphagia Digest, Vol 38, Issue 13
Hi Sherry, Our productivity is the same in inpt and op (I cover both but we do have some SLPs that are one or the other). Or requirement is 75%. If you do an 8 hour day it is 24 units. I do a 10 hour day so mine is 30 units. We are not allowed to account for any paperwork or insurance calls or down time in Radiology though. Treatments in both places are given a set rate for units in our Excel productivity grid. For example, all inpt treats are worth 2 units evals are 3, regardless of long it really takes you to do it. I don't know of any national standard but our requirements apply to all the hospitals in out health system.
Eileen McGowan MS, CCC-SLP
mcgowane at mlhs.org
Paoli Hospital
Paoli, PA
________________________________
From: dysphagia-bounces at b9.com on behalf of dysphagia-request at b9.com
Sent: Wed 1/17/2007 2:00 PM
To: dysphagia at b9.com
Subject: Dysphagia Digest, Vol 38, Issue 13
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Today's Topics:
1. Fwd: pediatric food aversion (Otpitt98 at aol.com)
2. help with pediatric oral aversion (Otpitt98 at aol.com)
3. Fwd: pediatric food aversion (Otpitt98 at aol.com)
4. standardized diets (Mary Joan McClure)
5. Productivity Standards (Edgar, Sheri L)
6. Re: Conditioned dysphagia (Buckie,Marcia)
----------------------------------------------------------------------
Message: 1
Date: Tue, 16 Jan 2007 21:18:56 EST
From: Otpitt98 at aol.com
Subject: [Dysphagia] Fwd: pediatric food aversion
To: dysphagia at b9.com
Message-ID: <c55.c377f7c.32dee190 at aol.com>
Content-Type: text/plain; charset="us-ascii"
sorry if this is a duplicate i posted it to the wrong address, thank you for
your help!
Michelle J. Storm, OTR/L
Occupational Therapist, Registered and Licensed NM #1899
Kids Unlimited
------------------------------
Message: 2
Date: Tue, 16 Jan 2007 21:23:06 EST
From: Otpitt98 at aol.com
Subject: [Dysphagia] help with pediatric oral aversion
To: dysphagia at b9.com
Message-ID: <d4c.7a07f.32dee28a at aol.com>
Content-Type: text/plain; charset="US-ASCII"
hello,
i have several toddlers who all have oral aversions and who all have g
tubes,,,,some of the kiddo's gag and make themselves throw up at just the sight of
the food
they will however, put everything else in their mouth, sorry for the
duplicate i thought forwarding worked,,,so if you get this twice, just ignore it,
thanks for your help
Michelle J. Storm, OTR/L
Occupational Therapist, Registered and Licensed NM #1899
Kids Unlimited
------------------------------
Message: 3
Date: Wed, 17 Jan 2007 01:11:54 EST
From: Otpitt98 at aol.com
Subject: [Dysphagia] Fwd: pediatric food aversion
To: sem at new-visa.com, dysphagia at b9.com
Message-ID: <d49.9fafa.32df182a at aol.com>
Content-Type: text/plain; charset="us-ascii"
as you can see my first attempt to email this out went to the wrong list,and
it didn't seem to post, but as you can see, i know it is a food aversion, and
i didn't mean to say oral aversion or to say that they make themselves gag or
vomit, what happens is when they see food they gag and vomit, nevertheless for
my mistakes i thank you for your reply,,i am trying to help a speech
therapist who approached me today about this kids to consult and was hoping to forward
these responses to her, so the info i have is also second hand, but her and i
both know it is a food aversion, simple typo
Michelle J. Storm, OTR/L
Occupational Therapist, Registered and Licensed NM #1899
Kids Unlimited
------------------------------
Message: 4
Date: Wed, 17 Jan 2007 08:58:34 -0500
From: Mary Joan McClure <mary.joan.mcclure at ncmail.net>
Subject: [Dysphagia] standardized diets
To: dysphagia at b9.com
Message-ID: <45AE2B8A.C48B764A at ncmail.net>
Content-Type: text/plain; charset=us-ascii
Does the facility at which you work use any kind of widely
recognized, "standardized" manual for preparing diets for people with
dysphagia? If so, what is it (e.g., National Dysphagia Diet, Maryland's
or South Carolina's Diet Manuals for Long Term Care Facilities)? Do you
use the recommended names of the diet levels, or just the preparation
guidelines while assigning your own names? Also, if you have time,
please address how/why the facility decided to use that particular
protocol.
We're evaluating procedures at our facility and are trying to decide
which manuals we will review. Your responses will be shared with a
"task force" made up of SLPs, OTs, dietitians, nurses, and other
professionals. Thank you very much for your help.
Mary Joan McClure, MS, CCC-SLP
Director of Speech, Language & Hearing Services
Murdoch Center
------------------------------
Message: 5
Date: Wed, 17 Jan 2007 09:50:34 -0500
From: "Edgar, Sheri L" <SLEdgar at LancasterGeneral.org>
Subject: [Dysphagia] Productivity Standards
To: <dysphagia at b9.com>
Message-ID: <BA091C9747361D47B5E119008867A24C0129B509 at MAIL-EK.lha.org>
Content-Type: text/plain; charset="us-ascii"
Good Morning~
I am looking for anyone who may have productivity "Industry standards"
for therapy services (PT, OT, ST) in the acute care setting.
I appreciate any information you may have.
Thanks
Sheri Edgar, MACCC/SLP
Lancaster General Hospital
Manager for Speech Pathology
sledgar at lancastergeneral.org
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------------------------------
Message: 6
Date: Wed, 17 Jan 2007 13:51:53 -0500
From: "Buckie,Marcia" <mbuckie at dmc.org>
Subject: Re: [Dysphagia] Conditioned dysphagia
To: "Pat Burns" <mcgill50 at comcast.net>, <dysphagia at b9.com>
Message-ID:
<D21E55BBE01B25449B68BF48358D39A061EE4B at dmc-mail4.dmcnt1.local>
Content-Type: text/plain; charset=us-ascii
For those of you in the Midwest, I just received a flier offer Dr.
Toomey's SOS course in the Metro Detroit area.
Marcia
-----Original Message-----
From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On
Behalf Of Pat Burns
Sent: Thursday, December 21, 2006 21:11
To: dysphagia at b9.com
Subject: [Dysphagia] Conditioned dysphagia
Hello Dale,
This is not an uncommon condition in the population that I treat - birth
to
5. Most of my kids have an intact swallow but the sensory ,
mechanical,
gut, or the poor learning experiences with eating because of these
issues,
are the problem. The variations in food acceptance across texture are
not
at all uncommon after a choking event.
All thoughts that follow are based on the Sequential Oral Sensory
feeding
protocol developed by Kay Toomey Ph.D. (Toomey and Associates Denver,
Co)
If you work with children or adolescents I highly recommend her
trainings.
SOS is absolutely the most "behavioral" feeding protocol I have ever
learned- and the absolute opposite of the traditional
" behavior" programs, and it works ( better, faster and more rational!)
The program I would use with this young man would be a variation of Dr.
Toomey's "Food Scientist " protocol.
I will provide some general thoughts-but there is nothing like training
with Dr. Toomey for developing a treatment protocol for a kid like this.
Look carefully at the mechanics of the chew. This child could be
overstuffing because of poor motor control - if he puts enough food in
his
mouth- eventually something will hit the teeth and get masticated! In
other
words was this kid a choking event waiting to happen?
Think about sensory awareness in the mouth. I suspect because of the
anxiety and ADHD you mentioned that this young man may have a problem
with
the sensory area. The mechanics are ok, but the feedback and awareness
are
off.
No matter what I did to treat the underlying cause of the choking
event, my
treatment program would include a lot of food exploration with the other
senses- how does it look, feel, smell, what happens when I smash it with
my
hand? I would do a ton of work across all 6 food textures with a lot
of
chewing and spitting out and evaluating the size of the masticated
pieces
against swallowable pieces. Also evaluation the size of the "bites"
because
I suspect there might be overstuffing. Give graphic representations.
Show
the size of a bolus that will go through easily- and the size of a "to
big
bolus" don't worry about segmental swallowing- you are teaching control
and
reducing anxiety about choking. I am talking about drawing a "swallow
sized"
circle, taking a bite, chewing it spitting it out and evaluating -is
this
too big, too small or just right to swallow. And how small are those
chewed
pieces? If I chew 10 times and he chews 10 times are the size of the
masticated pieces the same? It is gross-- but boy does it work.
Talk and learn about food in terms of its inherent properties. Bring
the
cognitive into the picture. Start with accepted foods and find foods
that
are similar but not exact in properties. Praise, praise every
interaction
with any non preferred food.
If you treat a varied and non dysphagic non eaters- SOS is the training
you
want!
Also, Dr. Toomey's office can refer you to a therapist trained in this
methodology in your area, and you can refer this young man to that
practitioner.
Hope this helps
Pat Burns
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End of Dysphagia Digest, Vol 38, Issue 13
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