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Implementation and Evaluation of ASHA NOMS Across the Continuum in the West GTA Stroke Region

Lindsay Benoit MA, CCC-SLP, Reg. CASLPO
William Osler Health Services
Pam Rahn MHSc SLP(C) Reg. CASLPO
Trillium Health Centre
Holly Sloan MS, CCC-SLP, Reg.CASLPO
Comprehensive Stroke Unit, Trillium Health Centre
Authors: Cynthia Boman, M.A., SLP Reg. CASLPO, Carmel
Forrestal Rehab Coordinator, West GTA Stroke Network, Roxanne
Mistry, MA, CCC-SLP Reg. (CASLPO), Nicole Pageau, Regional
Program Director, West GTA Stroke Network, Jodie Sutcliffe, Education
Consultant, West GTA Stroke Network

Background: In March 2010, ASHA NOMS (National Outcome
Measurement System) was chosen as the standard outcome
measurement tool for speech-language pathologists in the West
GTA Stroke Network. The Network coordinated a one year pilot
project to evaluate the implementation and efficacy of ASHA
NOMS across the continuum of care. The following organizations
participated: Trillium Health Centre, William Osler Health System
and St. Elizabeth Rehab.
Method: Participating SLPs used the ASHA NOMS online
training tutorial.
NOMS Functional Communication Measures (FCMs) were
administered on admission and discharge on patients/clients with
a diagnosis of acute stroke receiving SLP treatment for their
swallowing and/or communication disorder. Demographic and
service data was collected by the Network office on a quarterly
basis from September 1, 2010 to August 31 2011.
Patients were tracked across the continuum by use of a tracking
number assigned on initial admission. No patient identifiers
were used.
Results: Initial results revealed the most commonly treated FCMs
were: swallowing, expression, comprehension and motor speech.
This was true across the continuum.
In the in-patient rehab setting, more progress was evident on
the FCM for comprehension and motor speech disorders versus
expression.
In the out-patient setting, the motor speech FCM revealed the
most progress. It was noted that many patients made progress in
their expression and were discharged because their treatment
goals were met. However, this progress was not always measurable
by a change in the FCM indicating limits in the tool’s sensitivity.
Conclusion: Results to date show the ASHA NOMS is easy to
administer and useful in showing change, in communication and/
or swallowing function as a result of SLP intervention. We would
recommend its uptake regionally with opportunities to obtain more
data provincially.

For more information about ASHA NOMS click here.

Thoughts????

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