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Voice Therapy Survey at Kingston Hospital NHS Trust

 

Introduction

In 2003 the Speech and Language Therapy Voice Service was reorganised to accommodate a doubling of Voice referrals since 1999. The NHS Modernisation Agency: Action on ENT Good Practice Guide (2002) included the recommendation that 'Mechanisms should exist for involving patients, carers and the public' in evaluation of services'. Therefore a survey of patients' opinions was performed to inform further development of the Service.

Objectives

1)  To determine patients opinions of the Voice Therapy Service including:

     a) Communication

     b) Privacy and dignity

2)  To invite patient opinion on how the service could be modified and improved

Guidelines

• NHS plan 2000
• NHS Modernisation Agency: Action on ENT Good Practice Guide 2002
• Communication Quality: Professional standards for Speech and Language Therapists 1996

 

Standards

Taken from guidelines above:

 

'The client and the Speech and Language Therapist will establish agreement with regard to shared aims, expectations and responsibilities'

'An explanation of the causal and maintaining factors that make up the voice disorder will be discussed'

 

Sample

Patients discharged by the Voice Therapy Service over a one-year period in 2004-05. 62 patients were identified. 38 forms were returned completed, constituting a response rate of 61%.

 

Method

Questionnaire was designed by the Speech and Language Therapy Department in conjunction with the Audit Centre. The questionnaire was in scanable format using FORMIC questionnaire design format.

Questionnaires were dispatched by the Audit Centre to all on the sample list with a letter of explanation and a prepaid envelope for return to the Audit Centre.

Completed questionnaires were analysed using SNAP data analysis software.

 

Summary of results

The 30 respondents who had received the leaflet 'Advice about voice problems' all found it useful to some extent

• 89% (34/38) of respondents felt the therapist had explained the reasons for their voice/throat problem 'very well'
• 87% (33/38) of respondents indicated that the therapist had explained what she could do to help the voice/throat problem 'very well'
• 82% (31/38) respondents had goals completely explained to them by the therapist and of these, 65% (20/31) indicated that voice therapy had helped to achieve those goals. One further respondent, who felt goals had been partially explained, also felt that their goals had been achieved.
• 100% (38/38) respondents indicated that the therapist respected their privacy and dignity
• 95% (36/38) of respondents rated the quality of the service received from the Speech and Language department as 'very good' or 'good'.
• 21% (8/38) patients were seen within 4 weeks of referral.
• 24% (9/38) patients indicated that they found the waiting time for their first appointment to be 'unacceptable' and individual comments highlighted that they had not expected to have to wait so long.

Discussion

The results were discussed at the Voice Service Meeting and the Speech and Language Therapy Departmental meeting in June 2005. Generally patients appeared very satisfied with the service they had received. Some patients indicated that they found the waiting time for their first appointment to be unacceptable and individual comments highlighted that they had not expected to wait so long. An action plan was drawn up in response.

 

Action plan

• The referral acknowledgement letter sent to patients to be amended to state and explain reasons for the length of wait (for example, high referral rates and vacancies we are unable to fill) and to reassure that an appointment would be made and that the patient would not be forgotten
• The Voice Advice leaflet sent out with the referral acknowledgement letter to be revised to include further self help advice for the patient to begin applying while waiting to be seen
• Authorisation to be obtained to recruit to vacant voice posts

The survey was carried out by: Jean Kerr, Head Speech and Language Therapist; Kathryn Park, Speech and Language Therapist (Voice); Kate Lyons, Audit Facilitator. Acknowledgements to: Loraine Dodd, Speech and Language Therapist for assistance in the questionnaire design and Carlene Perris, Speech and Language Therapist (Voice), for assistance in questionnaire design and data collection.

 

 

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