Better Together: Interdisciplinary Collaboration in Medical Settings

Date: Saturday October 15, 2022
Time: 8:00 - 12:30
Format: Live Zoom with Recorded Option (Length available TBD)

Registration:

(Attendance to all four sessions is required to receive CE credit)

Schedule/List of Speakers and Timed Agenda:

8:00: Welcome and Introductions
Kathleen R. Cazzato, MA, CCC-SLP, BCS-S and Annette Alyafi, MS, CCC-SLP - Co-Chairs of Medical SLP Committee

8:15 - 9:15 - The Drain or the Pipes? Improving Interdisciplinary Collaboration Between Speech Pathology and Radiology Departments for a Streamlined Approach to Dysphagia Evaluation
Melanie Turner, MS, CCC-SLP and Laura Christensen, MS, CCC-SLP - Southern AZ VA Healthcare System

There is increasing evidence supporting the use of esophageal screenings, or “sweeps,” during Videofluoroscopic Swallow Evaluations (VFSS) to better visualize the oropharyngeal swallow in the context of the entire swallow system (Miles et al., 2014; McCarty et al., 2022). Unfortunately, speech pathologists and radiologists continue to report significantly different preferences for performing these esophageal sweeps (Hermann et al., 2002). To address this issue at the Southern Arizona VA Health Care System, SLPs designed a research project with two purposes. First, researchers calculated the prevalence of esophageal abnormalities in the outpatient videofluoroscopic swallow clinic to demonstrate the potential breadth of impact for this type of protocol. Second, researchers designed a screening tool - the Esophageal Dysphagia Evaluation Screener (EDES) – to better guide decision-making regarding when to implement esophageal sweeps. Using this information, SLPs arranged a presentation with the radiology department at the Tucson VA to review the findings from this study and recommend a specific protocol for implementation of esophageal sweeps. In this presentation, speakers will discuss not only the findings from their research but will also lay out a suggested framework for advocating for this type of change in your own facility.

9:15 - 10:15 - Artificial Airway and Positive Pressure Support: Respiratory Care Impact to Communication and Swallowing
Anne Miros, RRT, BSRT, Educator - Respiratory Services, Banner University Medical Center Tucson

A patient’s respiratory status impacts functional communication and swallowing abilities. For patient’s requiring the support of artificial airways, considerations re: respiratory status need to be well-understood as part of a patient’s overall treatment plan. This talk will serve to provide background information re: artificial airway options and discuss models of interdisciplinary collaboration between Respiratory Therapy and Speech-Language Pathology to optimize patient care and outcome.

10:15 - 10:30 - Break

10:30 - 11:30 - Models of Interdisciplinary Collaboration in an Outpatient Neuro-Rehabilitation Setting
Megan Grange, MS, CCC-SLP and Efrat Eichenbaum, PhD, Rehabilitation Psychologist, Center for Transitional Neuro-Rehabilitation, Barrow Neurologic Institute

Individuals with moderate-to-severe brain injury often experience significant challenges with communication, cognitive functioning, and mental health. As such, persons with these conditions often benefit from comprehensive neurorehabilitation provided by interdisciplinary teams that include SLP and Neuropsychology/Rehabilitation Psychology. This treatment model is well-represented at the Center for Transitional Neuro-Rehabtation (CTN) at Barrow Neurological Institute. During this presentation, we will discuss how we, a speech-language pathologist and a rehabilitation psychologist, have closely collaborated during our work together at CTN. We will discuss multiple interdisciplinary collaboration activities at CTN, including a Cognitive Compensations Group, individual therapy, and Cognitive Retraining, all of which involve close interdisciplinary collaboration. Time will be provided for Q&A, and we hope to engage the audience in discussion about how our model may apply to other medical treatment settings in which SLPs collaborate with other disciplines.

11:30 - 12:30 - Gender Affirming Voice and Communication: A Model for Interdisciplinary Gender Diverse Care
Lindsey O'Shea MS, CCC-SLP, Southern AZ VA Healthcare System

Transgender and gender diverse individuals may seek gender-affirming Speech-Language Pathology services to support the overall congruency of their voice and communication with their gender identity. Research in this domain indicates that voice incongruency with gender identity can negatively impact quality of life. Speech-language pathologists provide training and instruction in modifying voice and communication, addressing vocal pitch, resonance, intonation, articulation, language, and nonverbal communication. Collaboration with the patient is critical for setting treatment goals, as gender identity and communication needs are unique to each individual. This presentation will explore general assessment and treatment approaches for providing gender-affirming Speech-Language Pathology services to transgender and gender diverse populations, as well as discuss a model for interdisciplinary care.


Speaker Biographies

Meghan Grange is a speech-language pathologist on the Neuro Rehab Unit at St. Joseph's Hospital in Phoenix. She received her BS and her Master's degree at Brigham Young University. Her areas of clinical interest and expertise include stroke and TBI recovery, work and school re-entry following neurological events, social communication, and cognition. She has also worked in schools, assisted living centers, and pediatric outpatient settings. In her current role, she enjoys the diversity of patients she treats and the opportunity to provide not only treatment to patients, but education to their support system. She feels passionately about the SLP role in helping break down barriers to communication and human connection.

Efrat Hedges Eichenbaum, PhD, is a faculty rehabilitation psychologist in the Center for Transitional Neuro-Rehabilitation at Barrow Neurologic Institute. Dr. Eichenbaum specializes in evidence-based care of individuals with physical and cognitive disabilities and the support of their family members and caregivers. Her areas of interest include moderate-severe traumatic brain injuries, spinal cord injuries and disorders, multile sclerosis, chronic pain, and ethical decision-making in rehabilitation psychology. Dr. Eichenbaum is a member of the American Psychological Association (APA Division 22, dedicated to rehabilitation psychology). She currently serves as an APA Internship Site Visitor and as a member of the APA Opioids Initiative Advisory Group. Dr. Eichenbaum earned a master's degree and PhD in clinical psychology from Drexyl University in Philadelphia. She completed a doctoral internship in clinical psychology and a two-year postdoctoral residency in rehabilitation psychology at the Minneapolis VA Health Care System, where she trained at the VA Polytrauma Rehabilitation Center. Dr. Eichenbaum's research interests include posttraumatic growth after brain injury and prediction of neuro-rehabiliation outcomes, including the effects of placebo and nocebo factors.

Melanie Turner, CCC-SLP, is a faculty associate speech language pathologist at the University of Texas Southwestern Otolaryngology clinic. She received her Bachelor’s degree in Speech Communication Disorders and Spanish Linguistics from the University of Virginia, where she also worked in the NeuroVoice lab and conducted voice research sponsored by the Harrison Undergraduate Research Award. Melanie received her Master’s degree from the University of Arizona, where she completed her Master’s Thesis on the impact of age-related hearing loss on perception of age-related dysphonia. During Melanie’s clinical fellowship at the Southern Arizona VA Health Care Association in Tucson, Arizona, she conducted research on prevalence of esophageal abnormalities in the outpatient videofluoroscopic swallow clinic, using findings to support redesign of swallow evaluation protocols. Her current clinical interests include care of voice, swallowing, airway disorders, head and neck cancer, and laryngectomy populations.

Laura Christensen, CCC-SLP, is a speech-language pathologist at the Southern Arizona VA. She received undergraduate degrees in speech, language and hearing sciences and French linguistics from the University of Arizona. There, she completed research on lexical access in semantic variant PPA with Stephen Wilson, PhD, and worked as lab manager in the Speech, Language and Brain (SLAB) lab at the UofA under Edwin Maas, PhD. She went on to pursue her clinical master’s degree at Northern Arizona University where she completed a master's thesis on barriers to evaluation of individuals with aphasia. Her current clinical interests include swallowing and communication changes in individuals with head and neck cancer. She works closely with the ENT department at the Tucson VA to manage this caseload, conducting FEES studies, managing laryngectomies, and otherwise supporting these patients across the continuum of care. Laura has greatly enjoyed serving as PI for a recent research project with Melanie Turner, examining prevalence of esophageal abnormalities in the outpatient videoswallow clinic to facilitate relevant clinical change.

Anne Miros, RRT, BSRT, Educator has been a licensed respiratory therapist since 1994. During this time she has served in numerous patient care, leadership, IT and education roles. She has served on multiple interdisciplinary committees and taskforces with a focus on improving communication, quality, processes, and outcomes. She has delivered respiratory content lectures to therapists, nurses, and physician groups. During her career she has been integral in the development and maintenance of family and staff tracheostomy education programs that support all populations.

Lindsey O’Shea, M.S. CCC-SLP, is a Speech-Language Pathologist at the Southern Arizona VA Health Care System (SAVAHCS) in Tucson, AZ. She received her Master’s degree in Speech-Language Pathology from the University of Arizona and her Bachelor’s degree in Music – Vocal Performance from New York University. Her clinical interests include the evaluation and management of voice disorders, gender-affirming voice and communication, and higher-level cognitive-communication treatment. She is proud to be a part of the VA National Gender-Affirming Program with Speech (GAPS) and the VA National Transgender E-consult Program and is passionate about serving transgender and gender diverse Veterans.


After completing this course, participants will be able to:

  1. Describe the nature of interdisciplinary collaboration in an OP neurorehabilitation setting
  2. Identify specific areas of cognitive and communication function appropriate for interdisciplinary collaboration between rehabilitation psychology and speech-language pathology
  3. Describe examples of three different types of programmatic activities which involve interdisciplinary collaboration
  4. Define the nature of secondary pharyngeal swallow symptoms which may occur in the presence of a primary esophageal swallow abnormality
  5. Explain the purpose and benefits of an esophageal sweep protocol to be performed during video fluoroscopic swallow evaluations
  6. Demonstrate how to implement the Esophageal Dysphagia Evaluation Screening tool (EDES) to guide use of esophageal sweeps
  7. Describe a potential framework for use when advocating for change across departments
  8. Explain the impact of artificial airway options to managing ventilatory support
  9. Discuss various positive pressure support options for management of oxygenation and ventilation support.
  10. Participate in discussion around interdisciplinary collaboration RCP and SLP professionals can optimize safety and progression for patients toward effective communication and swallow function.
  11. Describe the components of treatment for gender-affirming voice and communication services
  12. Provide examples of appropriate outcome measures and assessment tools for the evaluation of transgender and gender diverse populations
  13. Identify professionals and available services to support transgender and gender diverse interdisciplinary care

 

 


Presenter Disclosures

Melanie Turner

Relevant Financial Information: Presenter received an honorarium from the Arizona Speech-Language-Hearing Association for this presentation. Presenter is employed by the University of Texas Southwestern Medical Center and will be referencing her employer during her presentation.
Relevant Non-Financial Relationships: The presenter has no relevant non-financial relationships to close.

Laura Christensen

Relevant Financial Information: Presenter received an honorarium from the Arizona Speech-Language-Hearing Association for this presentation. Presenter is employed by the Tucson VA and will be referencing her employer during her presentation.
Relevant Non-Financial Relationships: The presenter has no relevant non-financial relationships to close.

Anne Miros

Relevant Financial Information: Presenter received an honorarium from the Arizona Speech-Language-Hearing Association for this presentation.
Relevant Non-Financial Relationships: The presenter has no relevant non-financial relationships to close.

Megan Grange

Relevant Financial Information: Presenter received an honorarium from the Arizona Speech-Language-Hearing Association for this presentation. Presenter is employed by the St. Joseph’s Hospital and Medical Center and will be referencing her employer during her presentation.
Relevant Non-Financial Relationships: The presenter has no relevant non-financial relationships to close.

Efrat Eichenbaum

Relevant Financial Information: Presenter received an honorarium from the Arizona Speech-Language-Hearing Association for this presentation. Presenter is employed by the Barrow Neurological Institute and will be referencing her employer during her presentation.
Relevant Non-Financial Relationships: The presenter has no relevant non-financial relationships to close.

Lindsey O'Shea

Relevant Financial Information: Presenter received an honorarium from the Arizona Speech-Language-Hearing Association for this presentation. Presenter is employed by the Southern Arizona VA Health Care System and will be referencing her employer during her presentation.
Relevant Non-Financial Relationships: The presenter has no relevant non-financial relationships to close.