“Teleswallowing”: a case study of remote swallowing assessment

Abstract

Purpose -Telemedicine has enabled speech and language therapists (SLTs) to remotely assess swallowing difficulties (dysphagia) experienced by nursing home residents. The new technique, "teleswallowing", was designed by the Speech and Language Therapy Service at Blackpool Teaching Hospitals NHS Foundation Trust. It allows prompt assessment, avoiding potential risks of aspiration pneumonia, malnutrition, poor rehabilitation, increased hospital stays and reduced quality of life (Hinchey et al., 2005;Langmore et al., 1998). The purpose of this paper is to report on a second pilot of teleswallowing and the concomitant adoption study. Design/methodology/approach -The adoption study employed qualitative methods, including consultations with senior managers, semi-structured interviews with nursing home matrons/managers and nurses, two focus groups and semi-structured interviews with SLTs. The project clinical lead kept an activity log, which was used to estimate resource savings. Findings -Over a three-month period, six SLTs and 17 patients in five nursing homes participated in teleswallowing assessments. Teleswallowing benefited both patients and participating nursing homes. Better use of therapist time and cost savings were demonstrated and evidence showed that the service could be successfully scaled up. Despite this, a number of barriers to service transformation were identified. Originality/value -This is the first implementation of teleswallowing in the UK, but it has been used in Australia (Ward et al., 2012). The approach to engaging stakeholders to understand and address barriers to adoption is novel. The value lies in the lessons learned for future innovations.

Covid-19 and the ‘new normal’: are remote video consultations here to stay?

“…Telemedicine is perceived as a possible solution. Telemedicine has already been used to communicate directly with patients in their own homes, 26 as well as for consultations with patients and/or clinicians in other settings, for example, between district general hospitals and tertiary centres 1 ; nursing home staff and allied health professionals 3 ; care homes and Digital Care Hubs. 27 In these examples, telemedicine was seen as a way to increase access to healthcare for people living in remote/rural areas for whom limited access was the norm; this is now the new normal for most.…”

“…FaceTime, Skype, Lync, Webex) and used widely in both social and professional contexts. Responding to this opportunity, many innovative individuals within the health professions undertook painstaking practice and service development work to devise clinical protocols for a range of remote consultation interventions, referred to here as telemedicine (see for example Fetal Telemedicine 1 ; Telepsychiatry 2 ; Teleswallowing 3 ). These individuals acted as champions, often seeking external funding and promoting their own work to management, colleagues and professional institutions.…”

Using Telemedicine in Practice: Implications for Workforce Development

“…NPT requires significant resource and organisational commitment. The Stakeholder Empowered Adoption Model (StEAM) was developed as a modified approach where smaller scale studies are desirable (Bidmead et al 2015: 155-168, Bidmead and Marshall forthcoming, Ditchburn and Marshall 2017: 175-182, Marshall 2013; it uses elements of NPT and the Technology Acceptance Model (TAM) (Davis 1989: 319, Venkatesh et al 2003. The elements of NPT used were the framework of the four stakeholder groups, although in our studies we sometimes only focused on one or two of them (but always including professional staff).…”

Renal telemedicine through video‐as‐a‐service delivered to patients on home dialysis: A qualitative study on the renal care team members’ experience

“…The enablement of quick problem‐solving through videoconferencing is also evident in other telemedicine‐related areas. In a similar context, Bidmead et al () reported quicker swallowing assessments and shorter waiting times for older people living in care homes who received assessments via telemedicine delivered to them.…”