Aphasia Rehabilitation Service Delivery in a Stroke Rehabilitation Unit in Australia: A Clinical Audit of Speech Pathology Practices

Authors

Laleh Rej, Flinders UniversityFollow
Sebastian Doeltgen, Flinders UniversityFollow
Amy Rodriguez, Centre for Clinical Research Excellence in Aphasia Rehabilitation, BrisbaneFollow
Willem van Steenbrugge, Flinders University, South AustraliaFollow

Abstract

Purpose: To investigate service delivery of aphasia rehabilitation in a metropolitan rehabilitation hospital by speech pathologists and assess adherence to both the National Stroke Foundation (NSF) Clinical Guidelines and the Australasian Rehabilitation Outcomes Centre (AROC) database of benchmarks. Method: A retrospective audit of 34 discharged patients was conducted within a dedicated stroke rehabilitation unit from March 2012 to July 2013 in Australia. Discharge reports, Functional Independence Measure (FIM) scores and clinical time statistics derived from the organization’s electronic database were studied and compared with NSF’s Clinical Guidelines for best practice recommendations and AROC benchmarks. Results: Patients with aphasia were admitted to inpatient rehabilitation at an average of 21 days post stroke, 2 days beyond the AROC benchmark for inpatient rehabilitation. The mean length of stay of patients with aphasia was 60 days, significantly longer than the average AROC benchmark of 32.8 days. Patients received an average of 4.25 hours of speech pathology therapy per week, more than twice the minimum amount of therapy time recommended by the NSF Guidelines. Conclusion: The current clinical audit is the first known speech pathology audit investigating adherence to stroke and aphasia rehabilitation guidelines set forth by the NSF clinical guidelines and AROC benchmarks in Australia. By comparing current care with advocated best practice, strengths were identified in service delivery, as well as priority areas for quality improvement.

Author Bio(s)

• Laleh Rej, BSpPath, MSc Candidate, is a Master of Science student (by Research) in the School of Health Sciences at Flinders University, South Australia. She is also a practising Speech Pathologist with over ten years of clinical experience, specialising in adult rehabilitation.
• Amy Rodriguez, Ph.D., CCC-SLP is a Research Health Scientist in the Center for Visual and Neurocognitive Rehabilitation Center at the Atlanta Veterans Affairs Medical Center in Decatur, Georgia USA.
• Sebastian H. Doeltgen, MSLT(distinction), PhD, is a Senior Lecturer in the Discipline of Speech Pathology, School of Health Sciences, at Flinders University, South Australia and heads the Swallowing Rehabilitation Research Laboratory at Flinders University.
• Willem van Steenbrugge, PhD, is a Senior Lecturer (with full academic status) in the Discipline of Speech Pathology, School of Health Sciences, at Flinders University, South Australia.

Acknowledgements

This study was supported by a grant from the Allied and Scientific Health Office (ASHO) and the International Centre for Allied Health Evidence (iCAHE), ‘Contributing to Best-Evidenced Care Through Clinical Audits Initiative’. Many thanks to Dr. Saravana Kumar, the Medical Records team, and the Directors of Allied Health and Speech Pathology for their support with this study.

DOI

10.46743/1540-580X/2016.1592

Recommended Citation

Rej L, Doeltgen S, Rodriguez A, van Steenbrugge W. Aphasia Rehabilitation Service Delivery in a Stroke Rehabilitation Unit in Australia: A Clinical Audit of Speech Pathology Practices. The Internet Journal of Allied Health Sciences and Practice. 2016 Jan 01;14(2), Article 12.