Background: The role of Speech Pathology (SP) in the Intensive Care Unit (ICU) is well-recognised in improving patient communication and swallowing outcomes. To date, research has not explored the relationship between the presence of ICU-dedicated SP services and overall patient outcomes.
Aim: To determine whether the amount of ICU-dedicated SP staffing was related to length of stay (LOS) in hospital after ICU discharge for survivors who received invasive ventilation.
Methods: A retrospective cohort study drawing on ANZICS Registry data cross-linking Adult Patient Database and Critical Care Resources datasets. Patients who had received invasive ventilation and been discharged from ICU to a ward between July 2013 and June 2023 were included. Descriptive statistics and multivariable log-linear regression were used to investigate the relationship between post-ICU LOS (outcome) and the amount of annual full-time equivalent SP per 1000 patient-days (aFTE/1000) employed in each ICU.
Results: 191 ICUs and 421,897 patients met inclusion criteria. 122 (64%) ICUs reported a dedicated SP service for at least one year with a median FTE 0.20 (IQR 0.10-0.50) per site per year and median annual FTE 0.070 (IQR 0.046-0.123) per 1000 patient days per site. 237,832 (56.4%) patients had been in ICUs with an ICU-dedicated SP service. These patients were in larger public metropolitan and tertiary ICUs, had higher illness severity scores and longer duration of ventilation. They had a small but statistically significant longer LOS in hospital after ICU discharge (median 5.9 (IQR: 3.5-11.1) vs. 5.8 (IQR: 3.8-10.2) days p<0.001). However, after adjusting for confounders, there was an association between LOS and employment levels, with every unit increase in aFTE/1000 equating to a 41% decrease in post-ICU LOS (β -0.41, [95%CI: -0.66 to-0.17], p<0.001).
Conclusion: ICU-dedicated SP services are associated with shorter LOS in hospital after ICU discharge. Further research is required to determine the factors influencing this.