Utilizing an order set in a computerized provider entry system to increase speech pathology referrals in adult head and neck cancer patients

Abstract

<p><strong>Introduction.</strong> Treatment of head and neck cancers may include radiation therapy and side effects will result in swallowing difficulties that can lead to feeding tube use, malnutrition, and reductions in quality of life.&nbsp; Rehabilitation therapies are available and should be started before radiation treatment.&nbsp; Computerized ordering supports standardization of evidence- based order sets.</p> <p><strong>Objectives.</strong> The purpose of this study is to increase speech pathology referrals in adult patients undergoing radiation treatment for head and neck cancer.</p> <p><strong>Methods.</strong> A quality improvement project aimed at increasing speech pathology referrals was implemented using the PDSA (Plan Do Study Act) format. Chart review was completed to assess the baseline rate of speech pathology consults.&nbsp; An educational program was presented to providers after which an order set linking radiation and speech referrals was implemented.&nbsp; Post intervention data was collected, and chi square analysis was used to compare the difference.</p> <p><strong>Results</strong>Preliminary data analysis noted an increase in speech pathology referrals from 18% pre-intervention to 82% post-intervention, which is a 450% increase. The sample was mostly Caucasian, married, and had a diagnosis of larynx cancer.&nbsp; Almost all of the patients received chemotherapy with their radiation.</p> <p><strong>Conclusion.</strong> Using order sets will encourage referrals to underutilized services.&nbsp; Nurses should be aware of the benefits of speech therapy in radiation patients and should be encouraged to advocate for services and collaboration to provide improved outcomes for oncology patients.</p>