48.4% of left hemisphere stroke patients have aphasia. National Stroke Guidelines advise communication screening for all stroke survivors, to support early identification of communication deficits, and therefore early intervention and improved communication outcomes. At The Alfred, systematic screening is only conducted for swallowing, patients are referred for communication ad-hoc as identified by the multidisciplinary team (MDT).

AIM: To evaluate whether the implementation of language screening all left hemispheric stroke patients admitted to an acute stroke unit at a major tertiary hospital increases the early identification of aphasia.

Method: Pilot intervention with patient participants with a confirmed left hemispheric stroke admitted to the stroke ward during an 8-week period (June-July 2023). Patients were screened using the Frenchay Aphasia Screening Test (FAST) by trained Allied Health Assistants. Patients who failed the screen were referred to SP for communication assessment. Patients were not screened if already referred to SP, end-of-life pathway, new visual impairments or pre-existing communication deficits.

Results: 23 patients were admitted with left hemispheric stroke, with 12 (52%) diagnosed with aphasia. 17 (76%) were already referred to SP. Of the remaining 6 patients (26%), 1 on end-of-life pathway, 3 were discharged from hospital prior to screening being completed and 2 had a FAST. Of the two screens completed, only 1 patient failed the FAST, prompting a referral to SP to confirm aphasia. Therefore, the FAST screening resulted in an increase of 8% (N=1/12) of early aphasia identification.

Conclusion: Language screening of left hemispheric strokes admitted to The Alfred may contribute to a small increase in identification of aphasia. Administration of the FAST was feasible, approx. 15 minutes per patient. Current practices may be sufficient to support identification of aphasia at The Alfred, with incidence estimates consistent with literature. Streamlining screening procedures of stroke-related communication deficits including cognitive-communication should be considered.

At the conclusion of my presentation attendees will take away:
1. The benefit of aphasia screening to facilitate the early identification of aphasia post stroke
2. The use of multidisciplinary allied health assistants (MDT AHAs) in screening for communication deficits
3. Need for further consideration of streamlining communication screening processes in area of acute stroke