Introduction to Telepractice and Clinical Issues in Speech Pathology

Focus on adult populations, contrasting with previous discussions on children and early intervention.
Hospital settings: Popular among speech pathologists and audiologists.

Adults often present with both acquired and developmental diagnoses impacting speech and language.
- Acquired diagnoses: e.g., stroke, neurological incidents can occur following surgery.
- Developmental disabilities: Adults may enter hospitals for issues related to their lifelong disabilities.

Differences in terminology: Patients in hospitals versus clients or students in educational settings.
Aphasia: Commonly seen post-stroke. Diagnosis includes a range of assessments.
Swallowing difficulties often require a video swallow study following initial bedside evaluation.

Acute Care:
- Patients admitted for immediate treatment; includes ICU, surgery floors, etc.
Inpatient vs. Outpatient:
- Inpatient: Patients are hospitalized and receive services at bedside.
- Outpatient: Patients visit speech pathologists in clinics or outpatient therapy facilities.

Acute settings: Patient stays typically 3-5 days for intensive care.
Transition to rehabilitation facilities for continued therapy (usually 4-8 weeks, depending on insurance and diagnosis).
Multidisciplinary care: Collaboration with occupational therapists (OTs), physical therapists (PTs), and nursing staff.

Rehabilitation facilities may have outpatient services for individuals who have graduated from inpatient care.
Day programs often cater to individuals with intellectual and developmental disabilities.

Hospital settings involve interaction with various healthcare professionals including:
- Nurses and nursing techs.
- OTs, PTs, and respiratory therapists, especially in specialized units like ICU.
- Doctors from various specialties: hospitalists, neurologists, and radiologists.
Strong collaboration is essential:
- Speech-language pathologists (SLPs) evaluate swallowing and voice issues, often working closely with nursing staffs and respiratory therapists during assessments.
- Consult with lactation consultants for pediatric cases regarding feeding protocols.

Responsibilities vary by facility; SLPs often evaluate feeding and swallowing abilities but may overlap with OT or nursing responsibilities.
Importance of understanding the roles and culture of the medical facility for effective inter-professional collaboration.

Before conducting swallow studies, ensure the patient can communicate and follow directions. For example:
- Assess language and cognitive abilities prior to swallowing evaluations.
- Use varied skills while treating clients, as assessments may necessitate interdisciplinary skills.

Possible in health facilities but must ensure proper setup and protocols are in place for evaluations.
Continuity of care is important; having trained staff to assist telehealth services is essential.

Ensure patients can sit at a computer and follow directions appropriately for effective teletherapy sessions.

Hospital environments can be fast-paced and demanding, leading to potential burnout:
- Long hours typically include twelve to fifteen hour shifts.
- Productivity is closely monitored, necessitating self-care and realistic expectations.

Self-advocacy is crucial in work settings to balance workload.
Be aware of personal limits and capacity for handling high-stress situations.
Maintain a focus on personal well-being and mental health given the challenging environment of hospital work.

Encouragement to gain experience in inpatient settings as valuable for professional growth.
No assignments for the week, encouraging students to enjoy the learning process and reach out for any questions.
Reminder to nurture mental health and employ best practices within professional roles.