Reviewing the review process: examining decision-making in practice

Area of Science:

• Speech and Language Therapy
• Pediatric Healthcare
• Clinical Audit

Background:

• Significant variation exists in speech and language therapy (SLT) practice regarding the management of preschool children post-assessment.
• Current healthcare policies emphasize transparent decision-making, which is challenging without robust evidence.
• Case examples highlight contributing factors to practice variations.

Purpose of the Study:

• To investigate variations in SLT practice for preschool children.
• To identify reasons and factors contributing to these practice differences.
• To provide a framework for therapists to gather evidence for decision-making.

Main Methods:

• National multi-disciplinary audit of SLT practice.
• Analysis of case histories to illustrate contributing factors.
• Development of a practical evidence-gathering framework.

Main Results:

• Audit revealed inconsistencies in decisions regarding review or waiting list placement for preschool children.
• Case studies provided insights into the complexities influencing these decisions.
• A method for therapists to collect practice-based evidence was outlined.

Conclusions:

• Variations in SLT practice necessitate a move towards evidence-based decision-making.
• Therapists require tools to generate evidence for transparent and principled practice.
• The proposed framework supports therapists in developing individualized patient care strategies.