Improving client transitions between SLT teams in NHSGG&C : a knowledge exchange service development project

McCartney, Elspeth and Lloyd, Susie and Gray, Alison and Smart, Kirsty (2017) Improving client transitions between SLT teams in NHSGG&C : a knowledge exchange service development project. In: Royal College of Speech and Language Therapists Conference 2017, 2017-09-27 - 2017-09-28.

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Abstract

Introduction SLT services in NHSGG&C are offered from around 37 locations, managed within community and hospital, adult and paediatric units. SLTs work in teams serving specified populations, and facilitating client transitions amongst SLT teams is a priority. Researchers at Strathclyde University interviewed 28 SLTs and 7 service-users about successful and less successful transitions between the 21 SLT teams for adults with long-term SLCN, including unplanned transitions on entering acute services, and planned transitions on leaving school (McCartney & Muir, 2015, 2016). The overarching themes facilitating or impeding transitions, showing both negative and positive examples, were SLT team properties; communication and information exchange; and outside influences on teams. Following this, a University of Strathclyde and NHSGG&C SLT services Knowledge Exchange (KE) project was jointly funded, and a 'transitions' working group representing SLTs across all client groups formed. This group extended the research analysis, and suggested further service improvements. AimThe overall aim was to promote seamless care, improving clinical outcomes and patient safety due to reduced care gaps, and enhancing patient experience due to better communication and planning of transitions. Aimed-for improvements were: improved health outcomes and anxiety reduction through receiving good information and timely access to service;improved information and knowledge of available services for SLTs and SLT managers;improved information and knowledge about SLT team services for wider professional and service-user groups.Evidence used The evidence gathered by McCartney & Muir (2015,2016) was reported at a whole-SLT team conference. A 'transitions' working group covering all clients was formed in response to a call for members, and the research themes were agreed as relevant to transitions across the range of client groups. These were then used to scaffold further discussion, alongside professional examples and experiences collected from working group members and their colleagues, and from service-users who gave feedback to the group. Main outcomesThe working group: •developed and piloted a set of procedures to be employed to effect successful transitions and report outcomes, and a form to record these; •created a detailed directory of SLT teams, the clients served and services offered, with a dissemination and update plan; •developed a procedure to flag school leavers who had been discharged from SLT services at school but needed re-referral to plan post-school SLT interventions;•arranged for electronic record sharing for discharged service users who may be later referred to another team;•prepared a summary report and plan for further development of transitions pathways, including further development of accessible and compatible electronic patient records.ConclusionIssues influencing cross-team transitions identified in a research study were further considered in a formal KE service development project. The outcome was the construction of improved transition pathways constructed to meet the needs of clients within this large, complex SLT service, which are now being implementedImplications and future directionsCollection of SLT and client views about the new pathways is being undertaken, to monitor their utility and scope further improvements. Impact on SLTs and their clientsThere is an increased understanding of and procedure for implementing transitions, leading to increased client satisfaction, improved SLT team-working and information exchange, and improved SLT job satisfaction. Key wordsTransitions, pathways, developmentThree learning outcomes:1 Cross-SLT team planning of pathways is required to secure smooth transitions between SLT teams for clients.2 Transition pathways depend upon rapid access to client records.3 There remains a need for better public information on SLT services.For Conference ProgrammeResearch identified factors impeding or facilitating transitions between SLT teams in NHSGG&C. A Knowledge Exchange project between NHSGG&C and Strathclyde University validated these across other client groups. The project developed improved transition procedures, a form to record outcomes, and a directory of services. The process and outcomes will be presented.

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