Addressing quality improvement in community speech language clinics

Abstract

Objectives and participants: The perceptions about aspects of quality from the customers (patients/carers) point of view, Speech Language Pathologists (SLPs) and Management of the Speech Language Department (SLD) were investigated. Semi-structured interviews were carried out with management of the SLD and 16 service users whilst 3 focus groups carried out with 15 SLPs. The following questions were investigated • What is the current status of performance and how could this, through quality assurance, lead to a more effective and efficient service? • Which are the important standards for Speech Language services in the community to develop quality improvement? Analysis: Facilitated geographic accessibility, open referral, flexibility of appointments, and service offered free-of-charge at point of use were perceived to be important standards. A sound interpersonal relationship based on primary service provider, and confidentiality were common practice. Despite the fact that the SLD has had the Quality Service Charter (QSC) since 1999 (SLD, 1999) basic standards set by QSC Initiative (OPM 2000) are not adhered to. Service-users perceive provision as satisfactory and recommendable. Management was satisfied with the effort put by SLPs in their duties and lack of complaints by users. SLPs perceived that they delivered as best as they could despite the poor working environments, lack of resources and lack of policies. Conclusions and recommendations: Implications are that: Policies need to be developed to regulate aspects of service deliver and clinical practice. A Structural Changes Steering and Action Committee is required to take responsibility to handle problems related to structural issues. A customer care unit needs to develop and carry out internal and external customer satisfaction monitoring.