AN SLP ONCE TRIED TO TEST ME Making use of dynamic assessment, - - PowerPoint PPT Presentation
AN SLP ONCE TRIED TO TEST ME Making use of dynamic assessment, counseling strategies, medical history, and the interdisciplinary team for effective patient advocacy and treatment Will Farnham, MS CCC - SLP FUTURE COLLEAGUE COLLAB MAY 6,
FUTURE COLLEAGUE COLLAB MAY 6, 2020
Will Farnham, MS CCC-SLP
Making use of dynamic assessment, counseling strategies, medical history, and the interdisciplinary team for effective patient advocacy and treatment
OPEN KIMONO
Financial disclosures MedSLP Collective Affiliate (receive commissions, access) Full-time employee of Dysphagia Management Systems Earn profits from merchandise sales on my website/social media; media used herein Non-financial disclosures Appeared once on the Speech Uncensored Podcast
ORION PICTURES
Objectives/Learner Outcomes
thorough and accurate patient history in adverse circumstances
assessment administration and advantages/disadvantages of alternatives
strategies in post-acute adult rehab SLP intervention
practice as relates to interdisciplinary consultation
imperatives with respect to diagnostic, therapeutic, and interdisciplinary care
QUID PRO QUO, CLARICE
WITH SOME FAVA BEANS AND A NICE H&P
NETFLIX
Incomplete/delayed records transfers (Kind et. al 2011) Rashomon-style historians Limited patient/caregiver knowledge/insight Systemic implementation of the medical model Chief complaints vs unaddressed comorbidities
MEDICAL HISTORY BARRIERS
WHAT CAN YOU DO ABOUT IT?
Keep checking the chart Develop relationships at the prior levels of care
OVERCOMING HX BARRIERS
THE P IN HIPAA IS FOR PORTABILITY, NOT PRIVACY
Keep checking the chart Develop relationships at the prior levels of care Get as many historical perspectives as possible Scrutinize the med list Look at home meds vs current meds What’s the same, what’s new, what’s been stopped?
OVERCOMING HX BARRIERS
IT PUTS THE CLOCK FACE ON THE PAGE
BERNIE SANDERS CAMPAIGN
Institutional barriers Standardization barriers Time constraints Impairment severity Patient acceptability
BARRIERS TO STANDARD ASSESSMENT
WHAT CAN YOU DO ABOUT IT?
Doggedly advocate Spend your own money K.I.S.S.—Keep It Short, Speechie Patient Reported Outcome Measures Focus on function vs impairment Be comfortable with temporary uncertainty
OVERCOMING ASSESSMENT BARRIERS
THE BEST ASSESSMENT IS THE ONE THE PATIENT WILL COMPLETE*
*USUALLY
HIS THERAPY WAS GOING NOWHERE
Unconditional positive clinical regard Assumed competence Active listening Self-sharing Nonjudgmentalism Nondirective interviewing
RUDIMENTS OF COUNSELING
Counseling can feel “unproductive” Can increase patient buy-in Frequently helps to establish or entrench rapport Can increase agreeability to increased structure and complexity Patients who are comfortable sharing will share novel information relevant to history Open-ended expression reveals functional data about recall and executive function
COUNSELING AS DYNAMIC ASSESSMENT
I DO WISH WE COULD CHAT LONGER, BUT I’M HAVING AN OLD FRIEND FOR DINNER
Have confidence in your scope of practice Both general scope and also personal specializations Boundaries convey novel liberties
YOUR SCOPE AND THE IDT
KNOW YOUR GROUND SO YOU CAN STAND YOUR GROUND
Have confidence in your scope of practice Both general scope and also personal specializations Boundaries convey novel liberties Know your ground so you can stand your ground Have confidence in your knowledge of the case Be clear about the things you don’t know Does the patient have gaps in their history and active diagnoses?
YOUR SCOPE AND THE IDT
ASHA Code of Ethics: Principles of Ethics I
INDIVIDUALS SHALL HONOR THEIR RESPONSIBILITY TO HOLD PARAMOUNT THE WELFARE OF PERSONS THEY SERVE PROFESSIONALLY…
ASHA Code of Ethics: Principles of Ethics IV
INDIVIDUALS SHALL UPHOLD THE DIGNITY AND AUTONOMY OF THE PROFESSIONS, MAINTAIN COLLABORATIVE AND HARMONIOUS INTERPROFESSIONAL AND INTRAPROFESSIONAL RELATIONSHIPS, AND ACCEPT THE PROFESSIONS' SELF-IMPOSED STANDARDS.
Principle IV, Rule A: “Individuals shall work collaboratively, when appropriate, with members of one's own profession and/or members of other professions to deliver the highest quality of care.” Principle I, Rule B: “Individuals shall use every resource, including referral and/or interprofessional collaboration when appropriate, to ensure that quality service is provided.” Principle II, Rule A: “Individuals who hold the Certificate of Clinical Competence shall engage in only those aspects of the professions that are within the scope of their professional practice and competence, considering their certification status, education, training, and experience.”
YOUR SCOPE AND THE IDT
CONSIDERATIONS FROM THE ASHA CODE OF ETHICS
Thanks for being here; Check out the case
Thanks and apologies
Thanks
Speech Uncensored
Apologies
and Thomas Harris
FARNHAM IS VERY CLEVER, ISN’T HE, USING YOU?
FAIR USE IS A HECK OF A THING
Like you’d want to do that
email: williamfarnham@gmail.com memes IG: @hardtoswallowslp ethics/philosophy IG: @slpworldview
CONTACT INFO