Introduction: The Early Response Stroke Speech Pathology (ERSSP) project explored the feasibility of a streamlined model of speech pathology (SP) care for acute stroke patients.
Methods: The dedicated ERSSP service saw patients with acute stroke in the first 48 hours of admission at Sir Charles Gairdner Hospital (SCGH) across hyperacute to acute hospital settings. Data was collected prospectively on the SP service delivered. Patient outcomes were informed by the Stroke Foundation Living Clinical Guidelines for Stroke Management and feedback was sought from patients, carers, and the multi-disciplinary team (MDT).
Results: Over eight-weeks, 128 patients received care by the ERSSP service. Of these: 88% were seen within 24 hours of admission; 90% received assessment for rehabilitation within 48 hours of admission; and 80% of patients and/or carers received education regarding swallowing and communication impairments post-stroke. Of patients referred and clinically appropriate, 60% (n= 6) received an instrumental swallow assessment. Of the 40 patients alert and with family/carer present, 72% (n=29) received partner training to support/enhance communication skills. Eight carers/patients were surveyed, with 100% reporting improved knowledge of communication and/or swallowing disorders post-stroke. Five MDT members returned surveys with 100% reporting the ERSSP service an acceptable addition to stroke care at SCGH. Factors that positively impacted the project included having a SP position dedicated to the ERSSP service and MDT support. When there were staffing constraints, service comprehensiveness and timeliness was compromised.
Conclusion: The ERSSP service was an acceptable addition to the stroke service at SCGH, providing timely speech pathology care to patients with acute stroke in line with Stroke Foundation guidelines.
Relevance to clinical practice or patient experience: A dedicated ERSSP service facilitates the early management of swallowing and communication impairments for patients after stroke. Benefits include continuity of care across wards, early education, advocacy and access to rehabilitation.