STANDARDIZATION OF AN ACUTE CARE STROKE PATHWAY FOR SPEECH LANGUAGE PATHOLOGY
P. Letsos1, S. Somers2.
1University Hospital- London Health Sciences Centre, Speech Language Pathology, London, Canada.
2University Hospital- London Health Sciences Centre, Speech-Language Pathology, London, Canada.
Abstract Text
Background
To align with Canadian Stroke Best Practice Recommendations a standardized clinical pathway for Speech and Language Pathology (S-LP) was created and implemented for those requiring acute stroke services in an urban regional stroke centre (consisting of 26 stroke beds) in London, Ontario, Canada.  Acute stroke services in Southwestern Ontario were re-aligned to optimize access to timely interventions, resulting in an increase in the number of patients being admitted to our regional centre.  This caused the S-LP service delivery model shift from one clinician to several, providing a need for a coordinated, seamless pathway for assessment and management of communication and swallowing.  
Methods
An audit of current services revealed that clinicians were utilizing various, non- standardized swallowing and communication assessment techniques that were not comprehensive or timely. Adverse outcomes from inconsistent S-LP practices included failure to identify the extent of oro-pharyngeal dysphagia and communication deficits impacting discharge planning, patient safety and quality of life.  To effectively translate evidence into routine practice, a S-LP clinical pathway was implemented.
Results 
Preliminary analysis revealed a near 50% increase in the administration of more comprehensive and timely communication assessments for those acute stroke patients admitted to our regional stroke centre. Further review of the data suggested an upward trend towards the provision of more frequent and specific oral care recommendations for those patients with dysphagia.
Conclusion 
The implementation of a S-LP acute stroke pathway at an urban regional stroke centre has resulted in the standardization of care delivery irrespective of patients' day of hospital admission or service provider.