Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Enhancing access to speech pathology services for rural patients with Head and Neck Cancer (#126)

Jasmine Foley 1 , Elizabeth C Ward 2 , Laurelie Wishart 3 , Clare Burns 4 , Rebecca Nund 5 , Nicky Graham 6 , Corey Patterson 7 , Amy Ashley 7 , Julie Fink 7 , Emily Tiavaasue 8 , Wendy Comben 7
  1. School Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
  2. Metro South Hospital and Health Service and The University of Queensland, Buranda, QLD, Australia
  3. Centre for Functioning and Health Research, Qld Health, Buranda, QLD, Australia
  4. Royal Brisbane & Women's Hospital, Queensland Health, Brisbane, Queensland, Australia
  5. School Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
  6. Wondai Hopistal, Wondai, Qld, Australia
  7. Townsville Hospital, Townsville, Qld, Australia
  8. The Mt Isa Hospital, Mt Isa, Qld, Australia

AIM: Individuals who undergo treatment for head and neck cancer (HNC) require speech pathology services in the acute and long-term recovery phases. However, there are recognised service access barriers for individuals living in rural areas. Hence there is a need to increase the capabilities and capacities of rural speech pathologists to enable them to support people with HNC locally. The aim of this study was to evaluate the implementation of online training solutions and telehealth supports designed to assist rural speech pathology services increase capability to deliver HNC services, thus enabling patients to receive care closer to home.

 

METHODS: Two, 6-month service improvement cycles using the Plan-Do-Study-Act (PDSA) method were implemented. A hub-spoke service model was established between a tertiary speech hospital pathology service providing HNC care and 4 outer-regional/remote speech pathology services that previously provided limited/no services in HNC. In Cycle 1, digital training and up-skilling supports for HNC care were developed and implemented. In Cycle 2, HNC care commenced at the local sites, supported by telehealth to provide tele-handovers, e-mentoring and a shared-care model of service delivery.

 

RESULTS: The staff were able to identify multiple key areas for change and set goals for the two PDSA cycles targeting resource development, mapping service needs, upskilling/training and improving communication and handover processes between the hospital sites. A shared-care model was implemented successfully with 8 patients. Staff viewed the project positively and identified ways to ensure sustainability. Multiple deliverables were developed including rural learning portfolios and eLearn videos for training/skill development.

 

CONCLUSIONS: Strategies were identified and implemented which supported the abilities of local speech pathologists to offer post-acute care to people with HNC. The direct outcome of this project was rural patients accessing care closer to home - in areas where services had not previously been offered.