| | Caring For Patients with Speech and Language Disorders
PURPOSE
To measure the effectiveness of treatment for patients with motor speech and language disorders at Gundersen Lutheran.
BACKGROUND
Approximately one in ten people in the United States have some form of communication disorder, one million are aphasic (an impairment in the ability to use or comprehend words). These disorders are most commonly the result of stroke or traumatic head injury. Treatment for these disorders is provided in both inpatient rehabilitation and outpatient therapy settings. The efficacy and effectiveness of speech pathology services have been established for a variety of communication disorders at Gundersen Lutheran. The Speech Pathology Department is one of more than 400 treatment sites from around the nation that voluntarily participate in the adult component of the American Speech-Language-Hearing Association’s (ASHA) National Outcomes Measurement System (NOMS). Participating treatment centers submit admission and discharge Functional Communication Measure (FCM) scores on over 10,000 patients a year. The FCM is a quantitative tool that allows assessment of the effectiveness of treatment outcomes for spoken language comprehension, spoken language expression and motor speech disorders. The Speech Pathology Department uses the FCM to monitor patient progress in therapy.
AIM
Average FCM scores at Gundersen Lutheran will exceed NOMS benchmark for Spoken Language Comprehension, Spoken Language Expression and Motor Speech Disorder.
METHODS AND MEASURES
Patients are scored upon admission and discharge from therapy using the FCM seven-point scale, with a score of one indicating the patient’s communication or swallowing abilities are nonfunctional and a score of seven indicating the patient is independent. Patients must be 16 years or older and be seen for two or more consecutive therapy sessions in order to be included in the study. Organizations receive quarterly reports detailing the number of patients treated, average FCM score upon admission to therapy and the average change in the FCM score at discharge for each disorder treated. The report also provides the average change in the FCM score at discharge for all participating treatment sites.
BENCHMARK
American Speech-Language-Hearing- Associations National Outcomes Measurement System.
RESULTS
CONCLUSIONS
Qualitatively the results in treatment outcomes for spoken language comprehension disorders, spoken language expression disorders and motor speech disorders at Gundersen Lutheran were higher than the benchmark but statistical analysis could not be performed in that the national data were not provided in a comparative statistical format.
IMPACT
Patients receiving speech-language pathology services at Gundersen Lutheran can expect larger FCM increases on average at the conclusion of therapy.
NEXT STEPS
Continue to monitor and maintain results at this level of therapeutic effectiveness for treatment of communication disorders.
LINK TO REFERENCES
ACTIVITY LEADER
David E. Hartman, Ph.D., BC-NCD
Head, Speech Pathology, Department of Neurology
Clinical Director, Speech Pathology Services
ACKNOWLEDGEMENTS
Vicki R. Monk M.S., CCC-SLP, Julie C. Wise M.S., CCC-SLP, Lisa Collins-Secretary, Chris Heiderscheit RN, QPI
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