Transcript Aphasia - working in partnerships

Collaborative Working: Speech
and Language Therapy and the
Stroke Association
.
RCSLT Conference September
2012
Authors of the project
Katherine Scantlebury – SLT - Specialist Stroke Team,
.
Queen Elizabeth
Hospital, West Norfolk
Morag Bixley – Lecturer in SLT, De Montfort
University, Leicester
Gemma Smith – The Stroke Association
Communication Support Co-ordinator, West Norfolk
RCSLT policy statement 2007
“SLTs work in close partnership with other agencies
.
such as voluntary
organisations, social services, adult
education services and other public and professional
groups”
(The specialist contribution of speech and language
therapists along the care pathway for stroke survivors
p12)
National Stroke Strategy (2007)
“Specialised rehabilitation needs to continue across
the transition. to home or care home, ensuring that
health, social care and voluntary services together
provide the long term support people need”
(Department of Health p10)
Our service in West Norfolk
Specialist
Stroke
Services
approximately .3 years ago
commissioned
Both Acute and Community Speech and Language
Therapy and Stroke Association Communication
Support Co-ordinator roles were commissioned
Communication Support Co-ordinator
“Communication Support Services work with stroke
survivors and. their carers living with the effect of
communication difficulties. We work together to
develop effective communication strategies and
rebuild confidence”
(Stroke association 2012)
Communication Support Co-ordinator
“Working in collaboration with Speech and Language
. post holder will encourage clients to
Therapists…the
identify their personal goals and support their
achievement through a programme of group activity
or individual support as appropriate”
(Stroke association 2012)
Partnership working in West Norfolk
Close working in West Norfolk between Speech and
.
Language Therapy
and the Stroke Association
Communication Support Co-ordinator (CSC)
Developed and evolved with service
A literature search (Sept 2011) revealed no published
evidence examining collaborative or partnership
working between SLTs and CSCs
Aims of this pilot project
Define and evaluate this partnership between the SLT
.
stroke team and
the Stroke Association CSC role in
West Norfolk
Identify factors which may contribute to successful
joint working
Explore the use of grounded theory as a mechanism
to uncover the nature or and attitudes to partnership
working between SLTs and CSCs
Methodology - Grounded theory
A method of analysing qualitative data developed by
.
Glaser and Strauss
in 1967
“Grounded theory as a methodology has much to
offer speech and language therapists and
researchers…The benefit of the grounded theory
method…lies in its application to social processes and
human interactions” (Skeat and Perry 2008)
Methodology - Grounded theory
Using a grounded theory technique facilitates the
.
researcher to develop
a theory from the data collected
in a study, rather than to use the data collected to test
an already existing theory
Simmons-Mackie et al (2007) describe this grounded
analysis as a reflexive process through which common
issues and threads can be sorted into natural groups
and subcategories and contrasts can be identified
Methodology – research design
R&D approval gained
.
4 participants – the SLTs and CSC in West Norfolk
In-depth interviews carried out with each participant.
Questions were designed to be open and non
directive.
Interviews were recorded, transcribed and analysed
using grounded theory
Results
Defining West Norfolk communication pathway
Interview analysis identified a simultaneous,
collaborative, reciprocal, joint communication
pathway that started in the acute setting and
continued past discharge into the community and
through to long term communication support
Results
Defining West Norfolk communication pathway
Results
Evaluations were positive
“I see their role as a way of actually enhancing what
we are doing rather than substituting what we’re
doing or something different to what we are doing, it’s
something that gels everything together”
Results
Evaluations were positive
“I think it works extremely well and I hope it continues
to work this well… I’m happy in the way the service
works and I think it works well for the clients we have”
Results
Factors that may contribute to successful joint
working
Facilitators
Results
Factors that may contribute to successful joint
working
Two way
referrals and
re referrals
Facilitators
Results
Factors that may contribute to successful joint
working
“There is always a
door back into SLT if
they want that if they
need that they know
where we are and
that we all link
together”
Two way
referrals and
re referrals
Facilitators
Results
Factors that may contribute to successful joint
working
Two way
referrals and
re referrals
Facilitators
Joint
projects
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Two way
referrals and
re referrals
Facilitators
Joint
projects
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Two way
referrals and
re referrals
Facilitators
Joint
projects
Positive
working
relationship
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Two way
referrals and
re referrals
Facilitators
Joint
projects
Positive
working
relationship
“I know that X really wants the best and to do the best she
can for people with communication difficulties and so do I, so
we have joint goals in that sense even if sometimes our ideas
about how we provide that is different”
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Two way
referrals and
re referrals
Facilitators
Joint
projects
Positive
working
relationship
Continuity of SLT
& SA staff across
acute and
community care
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Two way
referrals and
re referrals
Facilitators
SA presence
on acute
ward
Joint
projects
Positive
working
relationship
Continuity of SLT
& SA staff across
acute and
community care
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Two way
referrals and
re referrals
Facilitators
Use of local
SLT training
expertise
SA presence
on acute
ward
Joint
projects
Positive
working
relationship
Continuity of SLT
& SA staff across
acute and
community care
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Regular
communication
Use of local
SLT training
expertise
Two way
referrals and
re referrals
Facilitators
SA presence
on acute
ward
Joint
projects
Positive
working
relationship
Continuity of SLT
& SA staff across
acute and
community care
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Regular
communication
Use of local
SLT training
expertise
Two way
referrals and
re referrals
Joint
projects
“We support each other, we
Positive
refer to each other, we talk to
working
Facilitators
people
about each other’srelationship
jobs and services which can
offer them the bestContinuity
supportof SLT
& SA staff across
possible”
SA presence
on acute
ward
acute and
community care
Results
Factors that may contribute to successful joint
working
Shadowing
each other
Regular
communication
Use of local
SLT training
expertise
Two way
referrals and
re referrals
Facilitators
SA presence
on acute
ward
Joint
projects
Positive
working
relationship
Continuity of SLT
& SA staff across
acute and
community care
Results
Factors that may be barriers to successful joint
working
Barriers
Results
Factors that may be barriers to successful joint
working
Boundaries
Barriers
Results
Factors that may be barriers to successful joint
working
Boundaries
Barriers
“I think the most difficult thing is having clear
identification of roles and where does SLT stop and CSC
working start … I think that’s something that can only
really be achieved by understanding each other’s roles
and responsibilities”
Results
Factors that may be barriers to successful joint
working
SLTs are
specialists
Boundaries
Barriers
Results
Factors that may be barriers to successful joint
working
“I think as an SLT it’s been a really useful learning
experience, in terms of what SLT is and what
requires a qualified SLT in terms of what we bring SLTs are
Boundaries about speech and language andspecialists
in our knowledge
what we know about research and evidence
therapeutically, what’s been published, what’s
being researched into at the Barriers
moment…So I think
its been a learning curve for me in learning what’s
precious to SLT and what are the things we should
be doing”
Results
Factors that may be barriers to successful joint
working
SLTs are
specialists
Boundaries
Barriers
Setting up the
service
Results
Factors that may be barriers to successful joint
working
SLTs are
specialists
Boundaries
Barriers
Lack of shared
management
Setting up the
service
Results
Factors that may be barriers to successful joint
working
“Our two services are
commissioned
and managed
Boundaries
totally separately which means
that if there are difficulties
between the two roles, there
Barriers
isn’t a manager that can sort it
out”
Lack of shared
management
SLTs are
specialists
Setting up the
service
Results
Factors that may be barriers to successful joint
working
SLTs are
specialists
Boundaries
Barriers
Lack of shared
management
Setting up the
service
Conclusions
Project defined and evaluated one example of service
delivery involving collaborative working between SLTs
.
and CSCs
Grounded theory was found to be a good method of
data analysis
Factors which may contribute towards collaborative
working and possible barriers to collaborative
working were identified
Conclusions
Further work is planned to extend the project and
. views of more participants in stroke
encompass the
services providing different communication pathways
For more details, please contact:
[email protected]