Our PICU and acute services at St Andrew's Healthcare are a unique setting, which require a tailored approach from Speech and Language Therapy (SaLT).
The high turnover of patients accessing the service, means that SaLT input needs to be provided at a faster pace than on our longer-stay rehabilitation wards.
SaLT challenges for PICU and acute services
Providing speech and language therapy into PICU and acute services offers unique challenges for our teams based at St Andrew’s Healthcare, compared to longer term rehabilitation placements. The reasons for this include:
- input needs to be faster paced as there is a higher turnover of people accessing the service
- there is generally limited information about a person’s communication needs available to the team
- people may be too unwell to engage in direct assessment on admission
Working towards a different therapeutic model
In recognising and seeking to address these challenges, our SaLT team have started to work towards providing a different therapeutic model, designed to meet the needs of patients within the context of PICU and acute care.
This approach includes our SaLT Assistant meeting directly with the Responsible Clinician and the MDT weekly, to triage the patient and determine if there is any support that can be given to the person or the staff working with them.
Often this takes the form of indirect support, for example; creating and providing easy read information, communication cards and emotions cards. In some instances, especially where neurodiversity is confirmed or suspected, or particular communication difficulties are observed, a person will then be seen directly by a Speech and Language Therapist to provide specialist guidance.
The positive impact of SaLT triage
This process has improved the efficiency and timeliness of input that our SaLT team can provide to patients who have been admitted to our PICU and acute services. For example, on one of our PICUs, a patient was admitted who was experiencing catatonia symptoms and was non-verbal. Through the triage process, this was identified quickly and a communication book was created and given to the ward to support the nursing team to communicate with the patient non-verbally. This was used temporarily to support the patient during their crisis period and once he began to improve, his communication returned to his baseline and he no longer required SaLT input.
Dr Iain Grant, Consultant Psychiatrist, has fed back on the positive impact for patients on our wards:
"We have found that, working very closely with SLT, has massively reduced restrictive practices on the PICUs. It has also reduced the amount of time that people have spent in more restrictive measures like long term segregation or seclusion nursing. Being really clear with patients has obvious advantages for communication, but also for progressing care, developing a therapeutic rapport and moving a person forward in their recovery journey."
PICU and Acute Bed Availability
