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Evaluating the Feasibility and Validity of Using Trained Allied Health Assistants to Assist in Mealtime Monitoring of Dysphagic Patients

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Abstract

Growing patient numbers, within a context of finite resources, has placed increased demands on dysphagia services in acute settings. Delegating some aspects of dysphagia management to other trained professional groups, such as allied health assistants (AHA), may help speech-language pathology (SLP) service efficiencies. The primary aim of this study was to explore the feasibility and initial validity of using trained AHAs to complete structured mealtime observations of patients. The secondary aims were to explore costs and user perceptions. The study used a mixed methods design. All AHAs who participated worked in the adult acute inpatient setting and were agreeable to participate; they successfully completed training and were deemed competent to use the observation tool. To explore validity, trained AHAs (n = 7) and SLPs (n = 5) conducted independent, simultaneous mealtime observations of 50 adult inpatients, using a structured observation form. Costs of AHA versus SLP time per average assessment were compared. Consumer perceptions were examined in semi-structured interviews with the AHA (n = 5) and SLP participants (n = 3). Exact agreement between AHA and SLPs on the overall pass/fail criteria was high (94%). Where exact agreement was not achieved, the AHA had made a more conservative decision. Salary costs and time savings for the SLP were identified. Interviews identified that both SLPs and AHAs perceived multiple positive personal and service benefits. High levels of agreement in clinical decisions and positive staff perceptions support feasibility and initial clinical validity. This model may assist SP efficiencies in services with high patient demand.

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Acknowledgements

The authors extend their thanks to the speech pathology and allied health assistant staff who helped to conduct training and participated in the data collection for this research.

Funding

The study was funded by the Queensland Health, Health Practitioners Research Grant (2015/2016).

Author information

Authors and Affiliations

  1. Speech Pathology and Audiology Department, Logan Hospital, Corner of Armstrong and Loganlea Roads, Meadowbrook, QLD, 4131, Australia

    Maria Schwarz, Anne Coccetti & Naomi Kalapac

  2. School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia

    Maria Schwarz & Elizabeth C. Ward

  3. Centre for Functioning and Health Research, Queensland Health, Brisbane, QLD, Australia

    Elizabeth C. Ward

  4. Menzies Health Insitutue, School of Allied Health Sciences, Griffith University, Brisbane, QLD, Australia

    Petrea Cornwell

  5. Metro North Hospital and Health Service, The Prince Charles Hospital, Allied Health Research Collaborative, Brisbane, QLD, Australia

    Petrea Cornwell

Authors
  1. Maria Schwarz
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  2. Elizabeth C. Ward
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  3. Petrea Cornwell
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  4. Anne Coccetti
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  5. Naomi Kalapac
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Correspondence to Maria Schwarz.

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The authors declare that they have no conflict of interest.

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Schwarz, M., Ward, E.C., Cornwell, P. et al. Evaluating the Feasibility and Validity of Using Trained Allied Health Assistants to Assist in Mealtime Monitoring of Dysphagic Patients. Dysphagia 34, 350–359 (2019). https://doi.org/10.1007/s00455-018-9947-y

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  • DOI: https://doi.org/10.1007/s00455-018-9947-y

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