Session Descriptions

Maximizing Outcomes for Medically Complex Patients of All Ages

March 17–29, 2021 | An Online Conference for SLPs

Realistic, Functional Interventions and Collaborative Services for Medically Complex Patients
James Coyle, PhD, CCC-SLP, BCS-S

This session will explore the complexities SLPs must account for when treating patients with complicated medical conditions, whose communication, cognitive, and swallowing difficulties are multifactorial. The speaker will discuss how SLPs can get a clear understanding of the impact of each medical diagnosis – and the interactions among them – on a patient’s functioning, and how to collaborate with other specialists whose expertise complements SLPs’ efforts. The speaker will explore how SLPs can provide thoughtful, systematic scaffolding designed to improve the health and function of damaged tissues/structures and physiologic systems, develop patient independence in the skilled performance of compensations and other behaviors that jump start recovery, and increase a patient’s investment and participation in the process.

After completing this session, you will be able to:

• explain the importance of aligning the mechanisms of the disease process to the mechanisms of treatment
• organize intervention efforts systematically to address restoration of impaired health of structures/systems, improve skilled performance, and enhance patient investment in the rehabilitation process

SLPs in the NICU: Supporting Infants and Their Families
Jennifer Casteix, MS, CCC-SLP

The typically unplanned journey through the neonatal intensive care unit (NICU) provides infants and their families with an early experience with interprofessional practice. This session will review common reasons for an infant’s admission into the NICU, describe the interprofessional team caring for these infants, and discuss the role of SLPs as communication and feeding specialists in the NICU. The speaker will examine neonatal abstinence syndrome, its cause, and the latest treatment strategies and outcomes. Finally, the speaker will touch on the importance of support and post-discharge care for these patients.

After completing this session, you will be able to:

• describe one strategy an SLP can use to support families with an infant in the NICU
• discuss two ways the interprofessional team supports an infant diagnosed with neonatal abstinence syndrome

Collaboration on the Pediatric ICU Rehab Team
Yun Kim, MS, OTR/L, Yiota Sennekis, PhD, CCC-SLP, and Hallie Lenker, PT, DPT

This session will outline the members, roles, and responsibilities of the pediatric intensive care unit (ICU) rehab team and describe areas of collaborative and independent decision-making to maximize the rehabilitative outcomes for pediatric patients across the continuum in the ICU.

After completing this session, you will be able to:

• identify the key members and roles on the rehabilitation team
• describe the individual treatment strategies used by each team member across the ICU continuum
• explain how the multidisciplinary team collaborates to maximize rehabilitative outcomes

Rehab Considerations for Adults With Complex Medical Conditions in the ICU
Dana Kilonsky, MA, CCC-SLP and Deadria Clarke, RRT

This session will address rehab considerations for SLPs working with adult patients in the intensive care unit (ICU). Speakers will discuss an overview of oxygen delivery methods, optimizing communication and dysphagia intervention for ICU patients, progressing patients with tracheostomy to successful decannulation, and maximizing outcomes for patients with complex medical conditions through multidisciplinary communication and collaboration.

After completing this session, you will be able to:

• facilitate communication and dysphagia intervention options for adult patients in the ICU, and safely progress patients with tracheostomy to decannulation
• explain the importance of multidisciplinary collaboration to maximize outcomes for ICU patients

Post-Intensive Care Syndrome in Adults and Children
Ann Parker, MD, PhD and Sapna R. Kudchadkar, MD, PhD, FCCM

Adult and pediatric survivors of critical illness commonly experience post-intensive care syndrome (PICS, or PICS-p in children), consisting of impairments in mental health (e.g., anxiety, depression, and post-traumatic stress disorder symptoms), cognition, and physical function. These impairments are associated with worse health-related quality of life and can persist for years after discharge from the intensive care unit. This session will describe the incidence of and risk factors for such symptoms as well as interventions to prevent and manage these impairments.

After completing this session, you will be able to:

• describe the core components of post-intensive care syndrome in children and adults
• describe strategies for prevention and management of post-intensive care syndrome, with special attention to the SLP’s role, including communication strategies

Approaches to Lifelong Care for Adults With Complex Medical Conditions
Lindsay R. James Riegler, PhD, CCC-SLP

Concrete recommendations and special considerations for adults with complex medical conditions remain sparse. This session will share big-picture strategies to consider when providing care for these patients.

After completing this session, you will be able to:

• describe current recommendations/considerations for adults with complex medical conditions
• identify ethical and cultural considerations for treating adults with complex medical conditions

The Role of the SLP in Palliative Care
Tiffany M. Mohr, MA, CCC-SLP, BCS-S, CBIS

SLPs often work with individuals in palliative care to improve their functional abilities related to dysphagia as well as communication, but the SLP’s role in end-of-life processes is more challenging to define. This session will explore the unique and rewarding role of the SLP in palliative care and end-of-life processes and describe how SLPs can provide support for swallowing and communication across the continuum of care and with a variety of populations.

After completing this session, you will be able to:

• summarize modern concepts in palliative care
• explain the SLP’s role within a multidisciplinary team working with the palliative care population
• develop swallowing and communication goals for patients in palliative care

Dysphagia Management for Medically Complex Patients in Acute Care
Molly Knigge, MS, CCC-SLP, BCS-S

Dysphagia may be caused by many underlying medical etiologies, and the hospital-based SLP must navigate a comprehensive world of medical diagnoses and be prepared to accurately evaluate and plan dysphagia treatment. This session will present a model for using medical chart review, online resources, swallow mechanism knowledge, and cultivated diagnostic and treatment skills to approach dysphagia in patients with any medical diagnosis.

After completing this session, you will be able to:

• list three aspects of the human neurologic system that may be affected in the acute stages of disease and the swallow mechanism examination signs to watch for
• identify one indicator each for potential or contraindication for dysphagia treatment in acute neurologic disease when planning intervention
• list at least three factors identified by clinical swallow evaluation that may indicate a need for instrumental assessment for treatment planning

Managing Dysphagia in Patients With COVID-19 in Acute Care and Beyond
Ashwini Namasivayam-MacDonald, PhD, CCC-SLP, SLP(C)

The COVID-19 pandemic has impacted our patients in unusual ways. Patients with COVID-19 can present with a variety of symptoms: from loss of taste and smell, to fatigue, shortness of breath, and coughing. This session will review current available evidence regarding best practices for dysphagia management for patients with COVID-19 in acute care and during their rehabilitation, including working through a case study.

After completing this session, you will be able to:

• summarize current and evolving evidence related to COVID-19 and effectively use it to inform patient care
• describe how to account for the symptoms of COVID-19 within a comprehensive assessment of swallowing
• design a treatment plan for COVID-19 that takes a multidisciplinary approach to care

Management of Chronic Dysphagia for Medically Complex Patients 
Paula Leslie, PhD, MA Bioethics, FRCSLT, CCC-SLP

SLPs’ work with patients with complex medical conditions and their families, and the focus is often on the initial or acute stages of conditions that affect eating, drinking, and swallowing. This session will address how SLPs can ensure best practice in the longer-term. The speaker will address the importance of understanding how a patient’s dysphagia fits into the bigger medical and quality-of-life picture, backed by bioethical considerations and evidence. The session will discuss how SLPs are not just one cog in a complex, interprofessional machine, but often the linchpin for optimal care of the patient and their family.

After completing this session, you will be able to:

• apply the narrative framework to a case in chronic dysphagia management
• compare patient/family- and SLP-focused perspectives of chronic feeding/swallowing difficulties
• describe the priority(s) of at least one other professional with whom you work, regarding the chronic dysphagia of your shared patient

Psychosocial Consequences of Prolonged Hospital Stays
Sejal Shah, MD

Prolonged hospital stays can impact patients in a variety of ways, having adverse effects on physical, financial, and psychosocial health. This course will explore psychosocial impacts such as demoralization and concerning psychiatric symptoms.

After completing this session, you will be able to:

• describe demoralization associated with prolonged hospital stays 
• identify concerning psychiatric symptoms such as depression and suicidal ideation 

AAC for Patients in Critical and Acute Care Settings 
Tami Altschuler, MA, CCC-SLP

Regardless of their age, patients in critical and acute care settings may experience communication difficulties due to the nature of their illness and the medical interventions they require. This session will discuss augmentative and alternative communication (AAC) for these patients, including evaluation and intervention considerations, resources, and materials to support AAC service delivery.

After completing this session, you will be able to:

• describe communication vulnerabilities and medical considerations for patients of all ages in critical and acute care settings
• identify resources and practice guidelines that promote communication access for patients in critical and acute care settings
• utilize elements of a feature matching assessment during a bedside evaluation of communication abilities

Medically Complex Patients: Coverage of and Payment for SLP Services
Shannon Butkus, PhD, CCC-SLP and Dee Adams Nikjeh, PhD, CCC-SLP

Coverage of and payment for SLP services for patients with complex medical conditions requires SLPs to navigate provider guidelines and payment systems related to multiple sites of service and multiple episodes of care. SLPs must also exhibit professional mastery of the principles of clinical decision-making pertaining to a continuum of care from intensive skilled treatment to maintenance intervention and termination of SLP care. This session will present critical information to support accurate payment for SLP services provided to patients with complex medical conditions. The speakers will share a pediatric and an adult case scenario and provide useful resources.

After completing this session, you will be able to:

• define payment systems (e.g., prospective, fee-for-service), practice settings (e.g., acute care, outpatient), and payer sources related to the continuum of care for patients with complex medical conditions
• articulate differences between skilled and maintenance intervention compared to unskilled services
• describe episodes of care and discharge criteria