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Speech Pathology Department Townsville Hospital and Health Service

Overview

The Townsville Hospital Speech Pathology Department, situated within North Queensland's largest tertiary hospital is dedicated to providing a comprehensive, evidence-based client-focused service. The Speech Pathology Department consists of 15 speech pathologists and a speech pathology assistant who are based in the following locations:

  • Townsville Cancer Centre
  • Rehabilitation Day Therapy Centre
  • Allied Health outpatient area
  • Women's and Children 's Allied Health Area

This department plays an active role in supporting speech pathologists in the Townsville Hospital and Health Service as well as networking with other speech pathologists throughout North Queensland and state-wide services . The development of the speech pathology course at James Cook University has expanded the teaching role as well as created a strong partnership in clinical education throughout the district.

What is Speech Pathology?

Speech Pathology is a health profession that diagnoses, manages and treats individuals who are unable to communicate effectively or who have difficulty with feeding and swallowing. Communication disabilities are a result of problems with speech, using and understanding language, voice fluency, reading and writing. One in seven Australians has some form of communication disability. 

Speech Pathologists work with people (and their family, carers, and other health professionals) as part of multidisciplinary teams and provide individual treatment, group programs, home-based programs and provide resources for ongoing management of communication and swallowing difficulties. 

Speech Pathologists working with the Townsville Hospital and Health Service provide a variety of services including:

  • Rehabilitation of communication and swallowing disorders following a stroke
  • Provision of Alternative and Augmentative communication options for patients with acquired communication disorders
  • Providing therapy programs for children with cleft palate, developmental delays, hearing impairment.
  • Give advice regarding feeding to a parent in the Neonatal Intensive Care Unit
  • Working with children and adults who stutter
  • Giving advice regarding swallowing issues post radiation therapy for patients with Head and Neck cancer
  • Diagnosing voice disorders and providing vocal rehabilitation
  • Performing fibre-optic endoscopic evaluation of swallowing and videofluoroscopic swallow studies for patients with swallowing disorders
  • Inserting voice prostheses for patients undergoing a laryngectomy
  • Working with patients after an acquired brain injury to help rehabilitate communication and swallowing functions.
  • Working as part of the multidisciplinary tracheostomy management team where they assess the patient’s swallow during cuff deflation trials and decannulation and manage the patient’s communication through various communication devices such as speaking valves.

Patient/Client Group

The Speech Pathology Department provides preventative advice, comprehensive assessment and speech pathology intervention within multi-disciplinary teams as well as within the Speech Pathology Department. The focus of clinical services at The Townsville Hospital is acute care for inpatients in the following areas:

  • Emergency Medical Unit
  • Medical Wards - including Acute Stroke Unit
  • Surgical Wards - including neurosurgery
  • Intensive Care/Coronary Care
  • Acute Mental Health
  • Oncology
  • Rehabilitation
  • Paediatric Ward
  • Emergency Department

Outpatient services are provided for people who have medical conditions with associated feeding and communication needs who require access to specialty services.

Specialty services are provided in the following areas:

  • Cleft Palate and Craniofacial anomalies
  • Swallowing/Feeding disorders
  • Neonatal follow-up
  • Oncology
  • Voice disorders/ENT
  • Videofluoroscopy Swallow studies
  • Fibre-optic Endoscopy Evaluation of Swallowing
  • Rehabilitation follow-up

Outreach services are also provided to the Parklands Aged Care Facility, Ingham Hospital and The Good Shepherd home to assist the discharge process and contribute to the continuity of care for these patients admitted to these facilities.

Clinics and Services

Clinics:

6 - 8 Child Development Assessment

Cleft Palate

Dysphagia
Feeding
FEES
Growth and Development
Head and Neck
Radiation Oncology
VFSS
Voice
   
Service: Day Rehabilitation

6-8 Child Development Assessment Clinic

This is a multi-disciplinary (Speech Pathology, Occupational Therapy and Physiotherapy) assessment clinic that is based at Kirwan Health Campus.  This clinic involves indepth formal standardised assessment and then collaborative report writing and feedback process for the family so that a wholistic understanding of the child can be made. Referrals accepted from parents, teachers, health professionals or doctors.

Cleft Palate Clinic

This is a multi-disciplinary clinic run in the Women’s and Children’s Clinical area every 2 months. The Senior Paediatric Speech Pathologist attends along with the Oral Surgeon, Paediatric Surgeon, Orthodontist and clinic nurse. Children born with a cleft palate and/or craniofacial anomalies attend this clinic with their families to discuss and plan their treatment with the cleft palate team. Children are referred to this clinic from all parts of North Queensland. Adults with cleft lip and/or palate are also eligible to be seen by the Cleft Palate Team.

Dysphagia Clinic

An outpatient dysphagia clinic operates in the Speech Pathology Department on Level 1. This service offers assessment and management for adults with swallowing difficulties and assessment prior to attending the VFSS clinic for instrumental assessment. This is a student clinic which is run by the Clinical Education Support Officer. During University Terms 3rd Year Speech Pathology students from James Cook University attend this clinic and participate in the therapy/assessment process. The clinic operates on a Thursday afternoon. Referrals can be made by a GP, specialist, allied health, nursing or the self referral.

Feeding Clinic

The feeding clinic is available to children and adolescents up until the age of 18 who have difficulty feeding.  This may be due to co-morbidities such as ASD, children with hyper- or hypo oral sensitivity, children who have developed a food aversion and fussy eaters.   The team consists of a Speech Pathologist, Dietitian and Occupational Therapist.   Referrals accepted from a Paediatrician or other health professional.

FEES Clinic

FEES is a standard procedure whereby a small flexible fiberoptic endoscope is passed through the nose to the hypopharynx to allow a visual examination of the pharyngeal stage of swallowing. It includes an assessment of laryngopharyngeal anatomy and physiology as it relates to swallowing, assessment of swallowing function (saliva and food/fluid) and swallowing intervention to determine which postural and behavioural strategies facilitate safer and more efficient swallowing.

  • Clinic runs fortnightly on Wednesday from 8am to 9am
  • Conducted in the Oncology Outpatient Department on the ground floor of The Townsville Hospital 
  • Conducted in conjunction with an ENT specialist and 2 speech pathologists

FEES referral process

A written referral needs to be made by the patient's treating doctor.  This can be a doctor at the Townsville Hospital, another facility, or a GP.  The referral needs to be sent to the Townsville Hospital Speech Pathology Department. 

Growth and Development Clinic

This is a clinic for children who have graduated from the Special Care Nursery with a history of prematurely, low birth weight and/or a complex medical issue.  Children are seen at the following corrected ages: 4month, 8months, 12month, 18months and 24months.  A Speech Pathologist, Physiotherapist, Occupational Therapist, Nurse and Neonatal Registrar are present for the clinic.  The focus of the clinic is on assessment and education of the family to promote development and educate regarding possible difficulties the child may have.  If developmental issues are identified that require ongoing therapy, referral to appropriate agencies is completed by the team.
 Head and Neck ClinicHead and Neck clinic

  • Clinic runs weekly on Tuesday 

Objectives for Speech Pathology:

  • Identify patients already with dysphagia.
    • Prevents further illness associated with dysphagia
  • Provide education to patients regarding dysphagia.
    • Primary prevention for those with or without dysphagia
  • Provides opportunity for prompt discussion with medical and allied team regarding swallowing prognosis.
    • Prior to treatment planning, advocating for prophylactic PEG  where appropriate
  • Preparation for Surgery/ Radiation/ Chemotherapy
    • Pre-Operative Counselling regarding communication and swallowing implications, as appropriate
    • Education to patients regarding implications and precautions for communication and swallowing during oncology treatments
    • Maintenance of function, including compensatory or habilitative treatment for oro-motor, swallowing, speech, and voice function.

 Liaison with associated facilities (i.e. other QLD health hospitals) regarding patient referrals and progress.

Radiation Oncology Clinic

  • Clinic runs weekly on Thursday
  • Conducted in radiation oncology outpatients dept- consult room 3
  • Conducted by a dietician and speech pathologist

Objectives:

  • Reduce hospital admissions, through avoidance of complications associated with aspiration etc
  • Maintain quality of life, through management of swallowing and communication difficulties
  • Provide education about radiation treatment and its effect on the head and neck region, specifically targeting:
    • Swallowing,
    • Oro-facial musculature,
    • Saliva management
    • Speech
    • Voice
  • Identify patients early who may be at risk of developing dysphagia
  • Follow-up patients that are already diagnosed with dysphagia
  • Encourage maintenance of function, including compensatory or habilitative treatment for oro-motor, swallowing, speech, and voice function.
  • Refer patients for instrumental assessment of swallowing ie: FEES or VFSS. 

Radiation oncology referral process

Referrals are accepted from medical, nursing and allied health professionals on MOSAIQ.

VFSS Clinic

A VFSS is a radiological imaging technique that allows for study of swallowing function in real time. It provides views of the anatomy and physiology of the oral, pharyngeal and upper oesophageal phases of the swallow.  VFSS is used to:

  • diagnose oropharyngeal dysphagia.
  • identify the severity, nature and pattern; and
  • evaluate compensatory swallowing techniques and manoeuvres to improve swallowing safety and efficiency.
  • determine safety of oral feeding and recommend behavioural swallowing strategies (eg. modification of food/fluids)
  • determine a swallowing rehabilitation plan and recommend further evaluation.
    • Clinic runs twice a week on Monday 1:30pm-:3:30pm, and on Friday 10am-12pm
    • Conducted in the medical imaging department on the ground floor of TTH 
    • Conducted by a radiologist, radiographer, and 2 speech pathologists

VFSS referral process

A written referral needs to be made by the patient's treating doctor.  This can be a doctor at the Townsville Hospital, another facility, or a GP.  The referral needs to be sent to the Townsville Hospital Speech Pathology Department.

Voice Clinic

A voice clinic runs weekly in the Speech Pathology Department (Level 1, Allied Health Outpatients). Initial assessment of the voice disorder, vocal education and therapy is provided in the clinic. This is a student clinic which is  run by the Clinical Education Support Officer. During University Terms 3rd Year Speech Pathology students from James Cook University attend this clinic and participate in the therapy/assessment process. The clinic operates on Wednesday mornings. An ENT referral needs to be received by the Speech Pathology Department prior to attending the clinic.

Day Rehabilitation Service 

An outpatient day rehabilitation service operates in conjunction with the inpatient rehabilitation ward at The Townsville Hospital.  The service offers goal-orientated post-acute rehabilitation for adults with ongoing speech, language and swallowing difficulties following an inpatient hospital stay.

Therapy blocks are client-centred and tailored to suit the needs of individuals and their families.  Therapy is offered in various forms and intensities including individual, group, via home programs and in collaboration with other disciplines.

Day Rehabilitation referral process

Referral to the day rehabilitation speech pathology service must be made through the Townsville Hospital Rehabilitation Consultant and Medical Team.  Patients may be referred to this service following an inpatient rehabilitation stay or through rehabilitation outpatient clinics.

 

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Community and Rural Services

Speech pathology services are also provided as part of multi-disciplinary teams in the community and at the following rural centres throughout the Townsville Hospital and Health Service.

Community - based at the Kirwan Health Campus

  • Children's Community Therapy Service - for children with physical impairment or requiring multi-disciplinary child development services
  • Community Health Services - providing primary health care for adults, both centre-based and at home
  • Older Person Allied Health Team - providing care for people over the age of 65 years
  • Child and Youth Mental Health Services - for children with emotional and behavioural difficulties
  • Women's and Children's Kirwan Speech Clinic - For children with communication impairments not requiring multi-disciplinary input

Rural Centres

  • Ingham Hospital
  • Ayr Hospital
  • Charters Towers Hospital with outreach to Hughenden and Richmond

Events and Initiatives

  • Currently establishing the Fibre-optic Endoscopic Evaluation of Swallowing Clinic in conjunction with the Ear Nose and Throat Specialists.
  • Working closely with Children 's Community Therapy Services to enable the smooth transition of all Child Development services to the community.
  • The establishment of a clinical educator for new graduates and students has further developed our strong links with the James Cook University and University of Queensland and has expanded our clinical education program.
  • Established a New Graduate network for all new graduates in the Townsville Hospital and Health Service and the and Mackay Hospital and Health Service
  • Speech Pathology Week Activities - Communicate to Participate 23-29th August was celebrated with displays in the hospital foyer and articles in the district newsletter. This week aims to demonstrate that speech pathologists are specialists who manage individuals with feeding and swallowing difficulties that may occur across all stages of the lifespan.

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How to refer outpatients - referrals will be allocated to the most appropriate service

 Paediatric Intake
 Location  Children's Community Therapy Service,
 Address  Kirwan Campus, 138 Thuringowa Drive Kirwan  QLD  4817
 Phone  +61 7 4433 9000
 Facsimile  +61 7 4433 9001

  Adult Intake
 Location  Speech Pathology Department
 Address  The Townsville Hospital, 100 Angus Smith Drive, Douglas QLD 4814
 Phone  +61 7 4433 2330
 Facsimile  +61 7 4433 2371

Inpatient Referrals

These referrals can be made directly to the speech pathologist on the ward by contacting their pager or dect phone or via Allied Health reception +61 7 4433 2370.

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Last updated: 26 November 2014