E-poster Presentation 2014 World Cancer Congress

Advancing multidisciplinary care and collaboration through the establishment of a dysphagia service at the Kuwait Cancer Control Center (KCCC) (#635)

Veronica Nickerson 1 , Stephen McAteer 1 , Daniela Fierini 1 , Rosemary Martino 2 , Debra MacGarvie 1 , Lisa Durkin 1 , Jennifer Deering 1 , Mariam Abdulrahman 3
  1. Princess Margaret Cancer Centre, Toronto, Canada
  2. University of Toronto, Toronto, Canada
  3. Kuwait Cancer Control Center, Kuwait

Background and Context: Head and neck cancer affects over 900,000 individuals globally. Of those newly diagnosed, 40% present with advanced disease, resulting in a high incidence of dysphagia – a comorbidity that leads to pneumonia and malnutrition. Establishing a multidisciplinary dysphagia service at KCCC with nurses, dietitians and speech-language pathologists is critical to management and eventual recovery of HNC patients.

Aim: To assess barriers and supports for a multidisciplinary dysphagia service for HNC patients in accordance with international best practice
To promote ongoing development of multidisciplinary collaboration through the creation of a dysphagia service
To advance scope of practice of dietitians and speech-language pathologists at both KCCC and in Kuwait

Strategy/Tactics: Prior to this initiative, there was no recognition of the risks associated with dysphagia, especially with HNC patients. This initiative supports KCCC’s strategic goal of advancing multidisciplinary care in accordance with international best practice.

Programme/Policy Process: A multidisciplinary team including local and international experts and composed of nurses, dietitians, and speech-language pathologists: analyzed the current state of service; conducted an educational needs assessment; developed discipline specific and joint education and training; and, established a service level agreement between referring partners.

Outcomes/What was learned: An interprofessional working group has initiated a formalized service whereby on-site dietitians screen patients for suspected dysphagia followed by referral to speech-language pathology assessment and management. SLPs from a local rehabilitation hospital provide service at KCCC given that no such services are available. Nursing developed a procedure and a self-learning module on dysphagia to ensure on-site sustainability. Dietitians developed texture-modified diets to support speech-language pathology assessment. Recommendations to increase dysphagia curriculum were offered to the Department of Speech-Language Pathology at Kuwait University and are now being incorporated to ensure ongoing dysphagia training, professional development and future growth of service.