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Life of the Health Care SLP:
Trends and Paradigm Shift
Gennith Johnson, MCD CCC-SLPAssociate Director, Health Care Services
ASHA
2
Disclosure
• Financial ASHA employee
Per diem employee of MedStar Washington Hospital Center
• Non financial relationships None
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Learner Objectives
• Describe current issues about professional issues related to health care-based services
4
Topics
2013 SLP Health Care Survey
International Classification of Functioning, Disability and Health (ICF)
Interprofessional Education/Interprofessional Practice (IPE/IPP)
Productivity Pressures
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• Fielded to 3,827 SLPs in health care
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Salary
33%
67%
Part-time Full-time
33%
56%
11%
Annual HourlyPer visit
Employment Status
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$70,000
$75,0002011
2013
Salary Trend
7%
Hospital Rehab hospital
Pediatric hospital
SNF Home health
Outpatient
$71,387$64,721
$69,144
$81,681
$69,095$64,000
Salary by Setting
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Hospital Rehab hospital Pediatric hospital SNF Home health Outpatient
19%17%
37%
16%
24%
18%
Funded, Unfilled by Setting
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ICF
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ICF Awareness and Use by SLPs
• ICF framework (body part/function, activity and participation, environmental factors) vs. coding system
• Adoption by other countries and professions• Considered for adoption by national electronic
data reporting• SLPs with no awareness: 51%• SLPs using ICF in documentation: 14%
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Focus on FunctionUsing the ICF for Functional Goal Setting
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Interprofessional Practice
• Evolving to improve patient care Physicians, nurses, pharmacists Understanding of other professionals’ roles
• Requires interprofessional education so incoming professionals are aware
• NOT merging scopes of practice• 31% report daily interprofessional collaboration for
treatment• Current reimbursement system is negative reinforcer
for IPP
Issues in Health Care Service Delivery
• Employer pressures 71% did not feel pressured Varied by setting
• Greatest: SNF• Least: Home health,
outpatient Provide inappropriate
frequency or intensity of services (5%-33%)
Provide services that are not clinically appropriate (2%-18%)
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Consensus Statement on Clinical Judgment in Health Care Settings
http://www.asha.org/uploadedFiles/AOTA-APTA-ASHA-Consensus-Statement.pdf
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Reporting Options
• Know Medicare guidelines!• Manager• Compliance officer in facility• ASHA Code of Ethics violation?• State licensure violation?• Medicare fraud hotline• State health department