On-The-Job Cross Pollination Part 4

As We Work, So We Learn

Jeremy has a complex cardiac condition, sensorineural hearing loss, fine and gross motor delays, and a severe speech sound disorder associated with a genetic syndrome. Michael has cleft palate, Pierre Robin sequence, and a host of feeding and developmental issues related to prematurity. Reed is ventilator-dependent after complex cardiac surgery and needs augmentative communication assistance while in the pediatric intensive care unit.

These children have complex conditions and multiple treatment needs. And they are the norm at St. Louis Children’s Hospital, a tertiary pediatric medical center where there is no such thing as an “easy” patient with a “simple” problem. That’s why no professional here works in isolation. Every child receives care from a team of professionals that can address a spectrum of needs.

The team approach carries over to our CE offerings. Each month we conduct multidisciplinary grand rounds lectures and journal clubs, in which we discuss recent pediatric journal articles. Audiologists and SLPs attend these functions side by side with colleagues from medicine, surgery, nursing, psychology, dentistry, pharmacy, nutrition, library, education, information technology and other specialties.

At a recent craniofacial grand rounds, for example, ASHA members, along with craniofacial surgeons, neurosurgeons, psychologists and nurses, explored the effects of changes in cranial volume following craniosynostosis surgery. And in a recent journal club, audiologists and otolaryngologists evaluated the evidence base regarding effects of frequency compression algorithms on amplification in children with high-frequency hearing loss.

Interestingly, turf issues are less of a problem in our pediatric area than in adult medicine. No one seems to take offense when I ask a nurse or a surgeon, “Why do you do it that way? Why not … ?” Likewise, I find that when a surgeon or nurse asks such a question of me, I often gain a fresh insight. My colleagues in feeding and swallowing have experienced some division-of-labor issues with OTs, but our joint-practice teams hashed that out, setting a mutually agreed-on hospital policy on who does what. Everything now seems to be going smoothly.

For many outside the medical setting, this shared method of learning may not seem entirely relevant to our work as CSD professionals. How does knowing about surgery for the skull affect the treatment we provide? In what way does knowing measures of radiation safety affect our evaluations of a patient? When we work and study side by side with other professionals, we bring a new perspective to what they do, and vice versa. Shared learning experiences build effective teams, and effective teams provide excellent patient care.

Lynn Marty Grames, MA, CCC-SLP, clinician at the St. Louis Children’s Hospital Cleft Palate and Craniofacial Institute, St. Louis, Mo.


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