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[Dysphagia] weekend coverage in acute care
We were just involved in a JCAHO mock survey last week and this topic came
up. The point made was that patients should receive equal service in your
facility no matter what day they enter the doors. At this point we
provide Saturday coverage (usually morning) to see dysphagia patients, new
consults, f/u's, etc. but if a consult comes in late in the day Saturday,
we are most likely gone so that patient waits until Monday morning. Same
with the Sunday consults. We have to change our practice and provide
Sunday coverage was the message from the surveyor.
Sally Gorski
Hennepin County Medical Center
Minneapolis, MN
"Connors, William A." <connorswa@ph.upmc.edu>
Sent by: dysphagia-bounces@b9.com
02/08/2005 11:06 AM
To
"Morgan Jennie \(RXP\) Speech & Language Therapy"
<Jennie.Morgan@cddah.nhs.uk>, "Patti Larghi" <plarghi@msn.com>,
<dysphagia@b9.com>
cc
Subject
RE: [Dysphagia] weekend coverage in acute care
Interesting approach - just stick an NG tube in 'em. I guess that's OK as
long as it's not my mother who is doing the waiting or is receiving the
uncomfortable NG tube unnecessarily. This seems quite a bit like
inequitable discrimination and providing different levels of care to
patients of similar levels and diagnoses which violates, in the U.S.,
acute care JCAHO regulations. What say you all?
-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On Behalf
Of Morgan Jennie (RXP) Speech & Language Therapy
Sent: Tuesday, January 25, 2005 10:07 AM
To: Patti Larghi; dysphagia@b9.com
Subject: RE: [Dysphagia] weekend coverage in acute care
It sounds like your patients get reasonable treatment only waiting up to
24 hours. Working in the NHS in Britian most hospitals do not have SLT
cover for weekends. If a patient is referred late on a Friday afternoon
then they have to wait until Monday morning before they are seen, which
means that they are NBM for the whole time.
Obviously this is far from ideal but we are not willing to lose our
Monday-Friday working practice. If a doctor is concerned about nutrition
and hydration then they often pass an NG tube until the patient can be
assessed by our department.
Jennie Morgan
Speech and Language Therapist
Durham
________________________________
From: dysphagia-bounces@b9.com on behalf of Patti Larghi
Sent: Tue 25/01/2005 14:53
To: dysphagia@b9.com
Subject: [Dysphagia] weekend coverage in acute care
I am hoping to get some feed back from those of you that work in an acute
care setting. More specifically smaller hospitals that don't have regular
weekend coverage. Firstly, we are trying to establish a protocal for
nursing to use as a screening tool to establish a need for an order for a
swallow eval.
The second part of the problem is covering the swallow evals once they are
written. Currently we use an on-call program. The SLP has 24 hours to
respond. The problem is of course those patients that enter the hospital
on
Friday p.m. and the physician writes on order for patient to be NPO until
evaluated by SLP. If our on-call therapist can not make it until Sat. p.m.
we feel this is an excessive length of time for the patient to wait but
at
this point we are in a dilema at to how to solve this issue.
Our nursing director suggested that the patinet receive a dysphagia diet
(Pureed honey thick liquids) until the eval and that the nurse be provided
with a screening tool to assure diet tolerance.
Anyway I would appreciate some feed back from those of you working in
simliar settings as to what your hospitals are currently doing to keep
patient safe and to provide nutrition in a timely manner.
Thanks, Patti Larghi
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