Background:
International studies have shown that SLTs provide safe and effective assessment for routine ENT referrals with dysphonia and dysphagia, thereby reducing ENT waiting lists. The safety and feasibility of SLTs assessing urgent/high priority patients has not been explored in Ireland. This study set out to examine the safety, feasibility, and effectiveness of a new SLT led clinic, screening and assessing urgent referrals with voice/swallowing complaints.
Methodology:
Stakeholder engagement was undertaken. Governance and risk management structures were established. Inclusion and exclusion criteria were agreed. Data was collected prospectively. Inter rater reliability was agreed between Clinical Specialist SLT and Otorhinolaryngologist.
Results:
172 referrals were screened. 45 referrals met the inclusion criteria. 39 patients attended for review. 79% of patients (n=31) were directly discharged with no ENT/SLT follow up. Principal diagnoses were as follows: Cancer detection rate 2.6% n=1, Smokers made up 51% of referrals. There were no known adverse outcomes/ misdiagnoses. Re-referral rate at 10 months was 5% (n=2).
Conclusion:
The pilot demonstrates that SLTs screening medium/ high priority patients with voice and swallowing complaints is safe, feasible and cost effective, with appropriate planning, risk management and hospital governance. Accurate disclosure of smoking status in referral information will assist with appropriate triage of referrals.