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Atrium Health

Speech Language Pathologist I, PRN, Winston Salem

Atrium Health, Winston Salem, North Carolina, United States, 27104


Job Description

Job Summary:

PRN POSITION IN ACUTE CARE, 2 SATURDAYS PER MONTH

Independently provides a full range of differential diagnostic and therapeutic services to medically complex pediatric and/or adult patients. Position may be inpatient and/or outpatient per needs of the department. Central or peripheral disorders may include communication, cognitive-linguistic function, language, phonological processes, articulation delays, oral motor/structural deficits, voicing, resonance, pragmatic deficits, alternative augmentative communication, feeding and/or swallowing.

Education / Experience: Master's Degree in Speech-Language Pathology Prior experience in acute care and with FEES Licensure, Certification and / or Registration:

CCC and NC license in Speech Pathology Current Certification from American Heart Association BLS for Healthcare Providers, CPR and AED. Essential Functions: Adheres to the general hospital standards to promote a cooperative work environment by utilizing communication skills, interpersonal relationships and team building.

Follows hospital policies and procedures. Follows departmental policies and procedures. Contributes to the overall quality of services. Assumes responsibility for keeping informed about changes in policies and procedures.

Performs comprehensive professional evaluations of patients of all assigned ages referred for differential diagnosis of communicative, cognitive-linguistic, feeding, and/or swallowing disorders.

Satisfactorily completes and maintains all initial and ongoing clinical competency requirements for patient groups and areas served. Appropriately selects, administers, and interprets diagnostic tools, with consideration of patient developmental level, current status, premorbid function, and reason for referral, and in accordance to WFBH protocols and procedures. Documents diagnostic findings, recommendations, and charging in the patient's medical record on the same day as evaluation. Notifies referral source promptly of results and consults with them, and other staff, as necessary to facilitate best care and outcomes. Follows institution guidelines for appropriate cleaning of tools utilized, as needed.

Ensures patient and/or caregiver education regarding communicative, cognitive-linguistic, feeding, and/or swallowing disorders and relevant treatment options.

Provides appropriate written and/or verbal counseling and education to patient and caregivers relative to recommendations, treatment options, and therapy carryover. Participates in patient and family conferences, as required. Documents education sessions in patient's medical record on the same day as provision.

Plans and conducts treatment programs for patients with communicative, cognitive-linguistic, feeding, and/or swallowing disorders

Satisfactorily completes and maintains all initial and ongoing clinical competency requirements for patient groups and areas served. Develops and implements individualized, functional, and measurable treatment goals, appropriate to evaluation findings and set goals. Incorporates patient and caregivers in treatment goal planning. Modifies therapy strategies and provides periodic re-evaluation to determine and ensure effectiveness of treatment, and to update treatment goals. Coordinates management recommendations with outside resources that will be participating in continuing care upon patient discharge. When appropriate, terminates formal treatment in an appropriate and timely manner. Documents therapeutic progress, and evolving plans and recommendations in the patient's medical record, utilizing objective data and submitting documentation on the same day as therapy provision. Consults with medical team, and other staff, as necessary to facilitate best care and outcomes.

Serves as speech pathology consultant to educational, medical, and other professional services

Interacts with other outside agencies as appropriate (for example, Vocational Rehabilitation, Assistive Technology). Continuously seeks to maintain or improve patient care services and evaluates opportunities to develop new services Identifies problems, contributes viable solutions, and readily adapts to change. Independently pursues knowledge and research relevant to areas of practice, and participates in in-service education programs to ensure proficiency in current techniques for the evaluation and treatment of all potential patients. Recommends new services and/or techniques to the Speech Pathology manager.

Evaluates options for augmentative/alternative communication and recommends and/or fits appropriate devices or prostheses to meet patient needs, as applicable

Consults with Assistive Technology as needed. Performs appropriate evaluation services to assess augmentative/alternative communication options or vocal prostheses. Instructs patient and family in the use of such devices; providing short-term therapy services with the device, if needed. Monitors performance with fitted device. Provides re-evaluation services, as necessary, to change or upgrade devices.

Ensures age/development appropriate patient care is provided in accordance with Age-Specific Care Guidelines for the specific age groups served.

Satisfactorily completes and maintains all initial and ongoing clinical competency requirements for patient groups and areas served. Demonstrates knowledge of physical, motor/sensory, psychosocial, safety and developmental factors in the Age-Specific Care Guidelines. Utilizes communication skills in obtaining information, providing education, and conveying patient needs sensitive to age and developmental level of the individual patient/caregiver.

Adequate performance on financial/budget and patient care expectations

Meets or exceeds productivity target consistently each year as defined by manager. Follows departmental guidelines for use of Benefit Time Off (BTO). Consistently and appropriately bills for services provided. Organizes and prepares Medicaid paperwork or coordination of coverage from other insurance when appropriate.

Per manager's discretion, experience within certain areas of clinical concentration(s) may be required for the position (determinant on work areas and job performance expectations).

Areas of Clinical Concentration:

Neurological Communication Disorders

Provide comprehensive differential diagnosis of speech and cognitive-linguistic disorders via standardized cognitive assessment tools (e.g., SCATBI, CLQT, MOCA), aphasia batteries (BDAE), and perceptual/acoustic motor speech evaluations. Assist referring physicians with the differential diagnosis process by providing advice about the nature of cognitive-linguistic deficits and potential neuropathologies and associated localization characteristics (probable area of brain causing the disorder). Identify functional limitations caused by such disorders and the impact on a patient's ADLs. Devise and implement evidence-based rehabilitation interventions to maximize functional outcomes for varying presentations of severity and medical complexity. Participate as core member of a WFBMC multidisciplinary specialty clinic (ALS and/or MS) upon request of manager. Dysphagia (adult)

Perform differential diagnosis of swallowing disorders via clinical and instrumental assessment using Modified Barium Swallow Studies (MBS) and/or Flexible Endoscopic Examination of Swallowing (FEES). Identify treatment options for dysphagia, including alternative means of nutrition (PEG or NG), diet modifications (thin/nectar/honey-thickened liquid), postural techniques, and exercise-based swallowing therapy. Provide evidence-based dysphagia rehabilitation utilizing sEMG, lingual manometry, respiratory muscle training, and pharyngeal strengthening exercises Head & Neck Cancer Dysphagia

Perform pre and post swallowing evaluations via FEES or MBS before patients begin radiation and/or undergo surgical resection of the head and neck. Assess and train patients on optimal adaptive feeding techniques such as lavage feeding, modified syringe feeding, glossectomy techniques, and all other compensatory strategies for oral and pharyngeal deficits post-surgery. Head & Neck Cancer Communication

Provide therapeutic intervention for intelligibility in the post-operative patient when indicated, utilizing compensatory strategies for intelligibility and/or compensatory techniques and exercises for lingual/labial/facial strength, range of motion, and articulatory competence. Manage total laryngectomy patients. Includes thorough pre-operative education on upcoming changes regarding anatomy and communication between inpatient and outpatient providers. Train patients on use of electrolarynx, HME systems, stoma support, and other stoma care products. Maintain a working knowledge of pertinent insurance coverage and assist patients and family members with ordering/obtaining necessary stoma care/cover supplies. Manage tracheoesophageal voice prosthesis (TEP) program.

Provide pre-op education regarding purpose, use, cleaning and maintenance of the TEP. Troubleshoot both chronic and urgent TEP issues, such as leaking, changes in voicing, dislodgement, loss of the prosthesis, or tissue changes. Fit patients for hands-free devices and provide all education and training.

Alternative Augmentative Communication

Assess augmentative/alternative communication options (low tech/high tech-speech generating devices) for patient/family Instruct patient and family in the use of such devices; providing short-term therapy services with the device, if needed. Consult with Assistive Technology as needed Coordinate and work with a variety of Augmentative device companies to lend out trial devices for communication before Augmentative devices are approved and distributed by insurance companies. Provide re-evaluation services as necessary, to change or upgrade devices. Voice

Collaborate in patient care with laryngologists and outside ENT referrals. Perform rigid and/or flexible video laryngostroboscopies to assess laryngeal function and biomechanics. Evaluate patients via use of instrumental, acoustic and/or perceptual measurements for differential diagnosis and to formulate recommendations/plan of care. Ability to individualize voice therapy through a variety of approaches (resonant voicing, unloading, voice building, breath management, kazoo buzz, VFEs, straw phonation, semi-occluded vocal tract exercises...). Evaluate new neurological voice patients via spectrogram both pre and post Botox to determine effectiveness of dosage. Educate patients on issues regarding vocal health and hygiene, potentially abusive vocal behaviors, irritable larynx syndrome, chronic cough and management of reflux through dietary and behavioral modifications. Provide therapy pre and post laryngeal surgery to optimize vocal outcome and reduce the risk of reinjury. Educate patients how to independently resolve episodic dyspnea related to paradoxical vocal fold movement through laryngeal control/respiratory retraining exercises, postural adjustment and optimization of typical respiratory patterns during speech and at rest. Singing Voice Specialist

Determine the effect of a voice disorder on the singing voice via detailed evaluation and knowledge of normal versus disordered vocal technique (avocational singers and professional vocal performers). Evaluate and document which symptoms are reflective of a vocal disorder versus poor technique to ensure insurance coverage. Aid patients in regaining pre-morbid vocal function to allow full (and safe) return to ADLs and/or job duties. Prefer Master of Music degree in vocal performance and pedagogy Auditory Habilitation Specialist for Children with Cochlear Implants/Hearing Aids

Auditory Verbal Therapist (AVT) Certification: 5 year program training clinician for specialization/certification in Listening in Spoken Language-Auditory Verbal Therapy for children with hearing aids/cochlear implants. Evaluate, develop and implement effective rehabilitative/habilitative programs and plans for patients with extremely delayed speech, audition, and language while following Auditory Verbal Therapy guidelines for appropriate strategies for parent education and continuation of audition development principles. Provide specialized audition habilitation services to pediatric cochlear implant patients unavailable at school systems and extremely rare in private speech pathology centers. Cleft Palate/Craniofacial Clinic

Collaborate with an interdisciplinary team including: plastic surgery, otolaryngology, genetics, orthodontics, dentistry, and audiology (other disciplines consulted as necessary). Provide feeding evaluations for infants with cleft palate to facilitate adequate nutritional intake for optimal growth and development, collaborating with the pediatric dentist who is involved in the naso-alveolar molding process for patients who have a unilateral or bilateral alveolar cleft. Conduct comprehensive speech-language evaluations for patients with cleft palate/craniofacial anomalies. Perform speech resonance evaluations including thorough articulation assessment and utilizing nasometry, cephalometrics and/or nasopharyngoscopy (in collaboration with a pediatric otolaryngologist) to assess the dynamic function of the velopharyngeal port during speech. Offer input regarding function of the velopharyngeal port during speech to plastic surgeons for patients who are being considered for surgical management for velopharyngeal dysfunction. Participate in annual screening and appropriate follow-up for patients with cleft palate/craniofacial anomalies through the completion of cranial growth (approximately age 18 years). Dysphagia (pediatric)

Provide ongoing counseling and recommendations to families about safe and effective feeding practices that they can carry-over in the home environment. Communicate closely and effectively with medical professionals to ensure adequate growth and nutrition of patients. Perform Modified Barium Swallow Studies and/or Clinical Swallow Evaluations (CSE) on the pediatric population to assess oral-motor function and identify any deficits in oral motor skills. Evaluate for signs of aspiration and trial strategies to prevent aspiration, as well as assess for indicators for the need for further evaluation and imaging (MBS/PFS). Perform feeding follow-ups for discharged NICU babies to ensure recommendations are being followed, address any questions/concerns from parents/families, and assess for ongoing swallow and feeding safety and need for any diet modifications. Educate patients and families on strategies that they can implement in the home and school environment to alleviate deficits including attention, memory, mental processing speed, word retrieval, etc.

About Us

Atrium Health Wake Forest Baptist is a pre-eminent academic health system based in Winston-Salem, North Carolina. Atrium Health Wake Forest Baptist is part of Advocate Health, which is headquartered in Charlotte, North Carolina, and is the fifth-largest nonprofit health system in the United States, created from the combination of Atrium Health and Advocate Aurora Health. Atrium Health Wake Forest Baptist's two main components are an integrated clinical system - anchored by Atrium Health Wake Forest Baptist Medical Center, an 885-bed tertiary-care hospital in Winston-Salem - that includes Brenner Children's Hospital, five community hospitals, more than 300 primary and specialty care locations and more than 2,700 physicians; and Wake Forest School of Medicine, the academic core of Atrium Health Enterprise and a recognized leader in experiential medical education and groundbreaking research that includes Wake Forest Innovations, a commercialization enterprise focused on advancing health care through new medical technologies and biomedical discovery.

Wake Forest Baptist Health, Wake Forest University School of Medicine and Atrium Health have joined forces in a strategic combination that will enhance care, transform medical education and create economic opportunity for countless lives in North Carolina and beyond. As a part of that combination, the two health systems will be integrating technology and platforms, including our career sites.

This means that although you are applying on the Wake Forest Baptist Health Career Site, you receive communications from the Atrium Health Recruitment Team. Please know that this is an expected process, and thanks in advance for your flexibility.

About the Team

Mission, Vision and Culture Commitments

Mission

To improve health, elevate hope and advance healing - for all.

Vision

To be the first and best choice for care.

Culture Commitments

We create a space where all Belong

We Work as One to make great things happen

We earn Trust in all we do

We Innovate to better the now and create the future

We drive for Excellence - always