Conference Proceedings | J Oral Health Dent. 2018;1(S2):A019 | Open Access

The 'One Stop' Parallel Swallow Disorder Clinic: A Collaborative Approach between ENT and SLT

Smith A, McInally K and Kirkland P

East Sussex Health Care NHS Trust, East Sussex, UK



Purpose: The “one stop” Swallow Disorder Clinic offers a quality holistic patient centered approach to the MDT management of swallowing disorders with shared leadership in a cost effective and evidence based framework.
Method: Retrospective analysis of referrals to ENT at Conquest Hospital was conducted for an 8 month period. These patients were not referred to SLT. A total of 57 patients were identified and their pathway mapped. Total length of pathway was 24 weeks with limited outcomes identified. A one stop parallel clinic was developed, redesigning the pathway with SLTs leading the process alongside ENT.
Results: The Pilot ran for 6 months. Waiting times reduced from 24 weeks to 5 weeks. Handoffs reduced from 5 to 1 improving flow and streamlining processes. Referrals for barium swallow reduced from 100% to 0% improving patient safety reducing unnecessary radiation. Video feedback improved patient understanding and management of their condition. Patient reported outcomes demonstrated 88% of patients found their appointment “very helpful”, 12% “helpful”. Among all, 75% scored at least a 7 on a 10 point scale (with 0 being not at all confident and 10 being extremely confident) indicating a high level of confidence in managing swallowing difficulties after the clinic.
Conclusion: The clinic, now funded permanently, maximizes clinical resources and provides patients with single pathway demonstrating how a collaborative approach between ENT improves pathways, outcomes and experience. This model is cost effective, capacity releasing and utilizes the advanced practitioner role in transformational change meeting the triple aim of “AHPS into Action” 2017.