Implementation of a speech pathology led laryngology post op clinic: an evaluation of service outcomes.

Abstract

Background: Patients traditionally require review by their Ear Nose and Throat (ENT) surgeon following laryngeal surgery for voice, swallowing and upper airway disorders. Post operative review appointments take up ENT consultation time and exceed the clinically indicated wait-times for Australian public hospitals. Aims: Evaluate the service impact of a Speech Pathology (SP)-led post operative review model of care on wait-times for post operative review and non-post operative ENT consultations, patient satisfaction, and diagnostic agreement. Method: 87 patients were seen by advanced practice SP in an Australian public hospital setting for their 6 week post operative review, using triage criteria and a standardised assessment protocol including clinical review, nasendoscopy/videostroboscopy. Recorded audio-visual nasendoscopy images were reviewed by an ENT laryngologist within 7 days to determine diagnostic agreement. Patients and staff completed satisfaction surveys. Results: 87 patients were seen across a 6 month period in October 2023 and May 2024. All patients (100%) were seen within their clinically indicated time period following surgery, compared with 49% prior to new model. There was a 96% reduction in patients waiting for their non-post operative review and a 61% reduction in the number of patients on the ENT Laryngology waiting list. Discharge rates were comparable. Diagnostic agreement between ENT and SP was 99%. No adverse events occurred. Patients reported a high level of patient satisfaction (96%) and ENT surgeon satisfaction (100%). Conclusion: SP-Led post-operative review of ENT Laryngology patients improved waiting times for patients post operatively and subsequently for new ENT patients. Comparable patient & staff satisfaction and discharge rates were demonstrated. There was high diagnostic agreement between SP & ENT and high patient safety confidence in this model.