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Prioritisation Systems Used in Adult Speech and Language Therapy Settings: A Scoping Review

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Title: Prioritisation Systems Used in Adult Speech and Language Therapy Settings: A Scoping Review
Language: English
Authors: Orla Gilheaney (ORCID 0000-0002-0041-783X), Carolyn Hulbert, Roisin Cullen, Kathleen McTiernan (ORCID 0000-0001-5863-0556)
Source: International Journal of Language & Communication Disorders. 2025 60(5).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 22
Publication Date: 2025
Document Type: Journal Articles
Information Analyses
Reports - Research
Descriptors: Adults, Speech Language Pathology, Speech Therapy, Health Services, Early Intervention, Communication Disorders, Eating Disorders, Evidence Based Practice, Decision Making, Best Practices
DOI: 10.1111/1460-6984.70123
ISSN: 1368-2822
1460-6984
Abstract: Introduction: Prioritisation is an important and necessary practice in speech and language therapy (SLT) departments, as the increasing demand for services often exceeds available resources. Despite being a key clinical activity within the profession, however, there is limited research on evidence-based methods for prioritisation systems (PS) used in adult SLT settings. As a result, the absence of standardised guidelines poses a risk of inconsistency in current prioritisation practices. This may lead to an unequal distribution of resources, potentially affecting patient well-being and outcomes. Methods: A scoping review was carried out which aimed to identify the PS used in adult SLT settings and to determine the facilitators and barriers to the development and implementation of effective PS in these settings. This study was conducted in line with PRISMA-ScR guidelines, with a protocol prospectively published (https://osf.io/dbtsf/). Six academic databases, three professional body websites, and two national health service websites were searched using a multi-tiered search strategy with assistance from a subject expert librarian. Data was charted regarding outcomes of interest, and critical appraisal using study design-specific tools was completed by two independent researchers. Results: Of the 10 studies eligible for inclusion, 60% identified dysphagia as a high priority for earliest intervention, with 30% consistently prioritising dysphagia over any communication deficits due to the medical implications of unmanaged swallowing problems. The majority did not address facilitators (60%) or barriers (80%) to developing or implementing PS. The absence of a standardised prioritisation system was noted throughout the included studies, with clinical judgement alone, non-standardised systems, or chronological order of referral commonly used in prioritisation. Conclusion: This scoping review examines the limited existing literature on PS in adult SLT settings, noting the lack of evidence-based or standardised systems. Further research is now needed to identify the critical factors which influence a clinician's prioritisation process prior to ultimately conducting subsequent research into the facilitators and barriers to developing and implementing evidence-based PS in order to establish best practices to improve patient care, experiences, and outcomes.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1484136
Database: ERIC
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  Data: Prioritisation Systems Used in Adult Speech and Language Therapy Settings: A Scoping Review
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  Data: <searchLink fieldCode="AR" term="%22Orla+Gilheaney%22">Orla Gilheaney</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-0041-783X">0000-0002-0041-783X</externalLink>)<br /><searchLink fieldCode="AR" term="%22Carolyn+Hulbert%22">Carolyn Hulbert</searchLink><br /><searchLink fieldCode="AR" term="%22Roisin+Cullen%22">Roisin Cullen</searchLink><br /><searchLink fieldCode="AR" term="%22Kathleen+McTiernan%22">Kathleen McTiernan</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-5863-0556">0000-0001-5863-0556</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2025 60(5).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: 22
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  Data: Journal Articles<br />Information Analyses<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Language+Pathology%22">Speech Language Pathology</searchLink><br /><searchLink fieldCode="DE" term="%22Speech+Therapy%22">Speech Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Services%22">Health Services</searchLink><br /><searchLink fieldCode="DE" term="%22Early+Intervention%22">Early Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Communication+Disorders%22">Communication Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Eating+Disorders%22">Eating Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Evidence+Based+Practice%22">Evidence Based Practice</searchLink><br /><searchLink fieldCode="DE" term="%22Decision+Making%22">Decision Making</searchLink><br /><searchLink fieldCode="DE" term="%22Best+Practices%22">Best Practices</searchLink>
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  Data: 10.1111/1460-6984.70123
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  Data: 1368-2822<br />1460-6984
– Name: Abstract
  Label: Abstract
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  Data: Introduction: Prioritisation is an important and necessary practice in speech and language therapy (SLT) departments, as the increasing demand for services often exceeds available resources. Despite being a key clinical activity within the profession, however, there is limited research on evidence-based methods for prioritisation systems (PS) used in adult SLT settings. As a result, the absence of standardised guidelines poses a risk of inconsistency in current prioritisation practices. This may lead to an unequal distribution of resources, potentially affecting patient well-being and outcomes. Methods: A scoping review was carried out which aimed to identify the PS used in adult SLT settings and to determine the facilitators and barriers to the development and implementation of effective PS in these settings. This study was conducted in line with PRISMA-ScR guidelines, with a protocol prospectively published (https://osf.io/dbtsf/). Six academic databases, three professional body websites, and two national health service websites were searched using a multi-tiered search strategy with assistance from a subject expert librarian. Data was charted regarding outcomes of interest, and critical appraisal using study design-specific tools was completed by two independent researchers. Results: Of the 10 studies eligible for inclusion, 60% identified dysphagia as a high priority for earliest intervention, with 30% consistently prioritising dysphagia over any communication deficits due to the medical implications of unmanaged swallowing problems. The majority did not address facilitators (60%) or barriers (80%) to developing or implementing PS. The absence of a standardised prioritisation system was noted throughout the included studies, with clinical judgement alone, non-standardised systems, or chronological order of referral commonly used in prioritisation. Conclusion: This scoping review examines the limited existing literature on PS in adult SLT settings, noting the lack of evidence-based or standardised systems. Further research is now needed to identify the critical factors which influence a clinician's prioritisation process prior to ultimately conducting subsequent research into the facilitators and barriers to developing and implementing evidence-based PS in order to establish best practices to improve patient care, experiences, and outcomes.
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