A Novel Collaborative Approach to Swallowing, Nutrition and Medication Management using digital technology

Sheiladen Aquino

Background to the Project

Difficulties with Swallowing (Dysphagia), is significantly prevalent in institutionalized elderly patients where at least 51% of residents are affected on a daily basis. Current research shows that post intubation due to Covid-19 and long-covid symptoms places patients at high risk of dysphagia and may exacerbate existing dysphagia symptoms that can lead to aspiration pneumonia, malnutrition, and non-compliance with oral medication resulting in increased hospital admission and reduced quality of life for care home residents.

The Project

This project will trail a new collaborative model of providing care using a remote telehealth digital solution.  It will explore a new integrated way of working between three specialist allied health services: Speech & Language Therapy, Dietetics and Nutrition, and Pharmacy. We aim to develop a single point of referral to eliminate bureaucracy and multiple waitlists. Care home staff will co-design a more efficient clinical pathway model to manage shared risks. We will also include the patient (when able) and their families in an attempt to deliver high quality care and relevant health outcomes for residents in care homes.

How this will be achieved

A Speech Therapist, Dietician and Pharmacist will conduct joint remote consultation sessions using a secure two way video link. They will direct Care Home Nurses and/or Senior Care Home Staff to assess swallowing, nutrition and medication needs of care home residents. These clinicians will also provide multi-disciplinary training to Care Home Nurses and/or Senior Care Home to contribute to skills development across health and social care.

We will conduct a two phase pilot (with a duration of 3 months each) with an evaluation component after each phase to provide any changes derived from evaluation forms, questionnaires, interviews and standardized outcome measures.

Anticipated benefits

Prompt access and integrated person centred approach to Dysphagia, Nutrition and Medication management means that patient deterioration can be prevented, admissions to hospital can be avoided and quality of life can be improved. This will help keep people well, advocate preventive care, promote wellbeing and provide care as close to home as possible thereby providing more capacity to clinicians. This project aims to present a new effective integrated model for the future provision of care for people with swallowing difficulties in Wales.