Patients with an altered airway require specialist speech pathology care, largely accessed face-to-face via metropolitan tertiary hospitals. The current, highly medical model highlights economic inefficiency and inequitable access for patients living in the regions. Speech pathology care is generally provided in person via the multidisciplinary oncology clinic, with scheduling based on availability with ear, nose and throat (ENT) specialists rather than clinical need. This contributes to overfilled clinics and inadequate capacity to focus on patient activity and participation. In the absence of a supportive community-based service, patients are commonly readmitted to hospital or have prolonged admissions due to the inability to provide structured, high frequency post-acute care to support transition home and into the community.

This quality improvement project investigates the feasibility of an alternate delivery model to meet these service demands. Utilising telehealth (video and phone calls) to extend standard onsite care, a novel proactive pilot service was designed and implemented. The pilot focusses on improving equity of access to speech pathology for those living regionally and preventative interventions to avoid adverse events and improve client outcomes following altered airway surgery.

Collaboration with clients, carers and health providers has informed the strategic direction of the pilot and facilitated service development that responds to the needs of consumers. Authentic consumer consultation has been achieved via ongoing constructive input from our current client cohort and a dedicated consumer advisory panel to design a desirable and sustainable model of care.
Data collection and analysis is currently in progress to evaluate patient flow through the health network and clinical outcomes. Key results will be provided in the presentation.

1. Understand the process used for co-production with consumers for a model of care
2. Outcomes of using a novel preventative community based service via telepractice with people with an altered airway, including what clinical factors linked to improved patient outcomes
3. Challenges and barriers to implementation of this pilot model of care and learnings to consider when implementing a mulitmodal model