When to Phone a Friend

Music:
[0:00] Music

Speaker1:
[0:16] Everyone, this is Emily.

Speaker0:
[0:17] And this is Eva.

Speaker1:
[0:18] And you're listening to Speech Talk.

Speaker0:
[0:21] We're your research book club so you can do evidence-based practice in practice.

Speaker1:
[0:25] So let's get talking.

Speaker0:
[0:26] All right. Welcome back to another episode. Today, we're going to jump into learning about interdisciplinary communication to ensure quality patient care. And I have been thinking a lot about this at work because my gosh, have the number of like diet orders that have come in that do not match what the hospital record says and just doing endless, what feels like endless in servicing about IDDSI to what we call them in the buildings, which is not on the IDDSI scale. And just trying to report patient changes and feeling like a lot of times those notes are not making their way to progress notes or physician's orders.

Speaker0:
[1:11] I don't know why. I feel like it was just kind of like a frustrating week. And so I'm really fired up to talk about interdisciplinary communication today.

Speaker1:
[1:19] So it is so important to keep Eva not fired up.

Speaker0:
[1:23] But- Keep me down.

Speaker1:
[1:26] We don't need to be fired up, Eva. Not all the time, at least. A little fire's good. But it is important for this collaboration. Our collaboration among healthcare professionals is an important factor for patient outcomes. And patients often have complex needs that require expertise from various disciplines. Like, we absolutely don't know everything. We need to talk to our nurses.

Speaker0:
[1:47] I know sometimes it feels like we know everything, but it's just not true.

Speaker1:
[1:51] And I sometimes get those patients where they're like, You feel so smart, don't you? And I'm like...

Speaker0:
[1:57] Yes, yes, I do feel smart.

Speaker1:
[1:59] Yes, I do. Thank you. And I'm helping you. But we want to talk about how these disciplines help us and they help the patients and how to get those disciplines involved with us.

Speaker0:
[2:11] A hundred percent. That interdisciplinary approach really is important.

Speaker0:
[2:14] So the research article we looked at is Impact of the Communication and Patient Handoff Tool SBAR on Patient Safety, a Systematic Review by Stock et al. Emily, can you please kick us off by talking about what the SBAR is?

Speaker1:
[2:31] Quick aside, Eva, I think that you need to be the next voice of Siri.

Speaker0:
[2:36] Thank you. Oh, my gosh. I've always wanted to be the small voice in everyone's phone.

Speaker1:
[2:43] So SBAR, it's an acronym for this method of communication, right? S stands for situation. So what is happening with this patient?

Speaker0:
[2:53] What is happening?

Speaker1:
[2:54] B is for background. So what were their prior levels? And this is also where you include any pertinent information to the situation at hand. Then we go to A, assessment. So what do you think is happening? What are your concerns? what is the course of action that is needed? And then recommendation, this is where we're reaching out to other disciplines. Like, what do you recommend for the situation? How are we remediating what's going on?

Speaker0:
[3:20] Yeah, our recommendation, that's where you call a friend.

Speaker1:
[3:24] In the research article, they implemented this form of communication to learn if the implementation of SBAR would show impact to patient safety and to summarize those results. So specifically, they looked at whether or not the SBAR usage improved team

Speaker1:
[3:41] communication, patient handoffs, communication and telephone calls from nursing to physicians.

Speaker0:
[3:47] Yeah. And a quick note, this is a systematic review. So they weren't the ones implementing the communication form, but they looked at other research where the communication form had been implemented to look at those outcomes that Emily just listed. And what did they find? Their research looked at 26 patients. Eight had significant improvements when their healthcare professionals were using the SBAR. Eleven had slight improvements. Six had no improvements. And surprisingly, one had negative results. I can only imagine that it was like, I had like an incorrect allergy or just like the wrong patient information. Like their leg got cut off and it was not supposed to. I don't know what the negative results are, but I'm imagining something comically terrible.

Speaker1:
[4:35] Or don't you just like, it's one of those. My bad if they died. Yeah, you're bad if they died. It's one of those things where like, it was probably like a negative Nelly, right? Like, this facility has been operated. We don't need these speech recommendations. Get out of here with your new wave things.

Speaker0:
[4:54] Get out of here with the communication tools. I'm not going to do it.

Speaker1:
[4:57] Oh, it's trying to talk to me.

Speaker0:
[5:00] The researchers deemed the study was indicative of moderate overall improvement. They were like, some had really good improvements, some had so-so. So overall, they kind of summarized that as moderate improvements to patient care. But they did highlight that it was particularly helpful for phone-based communication for clarity. And they noted that there's certainly more room for research to be done. I don't know how comprehensively they looked when they were trying to do their

Speaker0:
[5:27] systematic review, but from their side of things, there could have been more.

Speaker1:
[5:32] Yeah, and the research really just wanted to look back on why these communication tools are important. And they said that communication breakdowns have been repeatedly identified as a major source of adverse events and medical errors.

Speaker0:
[5:46] So, yeah, that's pretty serious.

Speaker1:
[5:48] Well, you might have those negative Nellies like, man, don't you put this like that's where our bad things are coming from is lack of communication.

Speaker0:
[5:58] So I do like your negative Nellie voice. I'll say that. Yeah, it starts with an angry meow. But it's really important. And so for adverse events, a common one we see is poor communication with registry or clipboard PR and nursing staff. And we'll, we have these like cognitively very like high level presenting patients who will be like, oh, my Walker is in the rehab gym. And we'll have people who don't know the patients very well come in like, oh, I'm just grabbing Walker for our patient. We always ask, what's the name? They'll give us the room number. Go, what's the name? We go in and we see what patient it is. and we're like, oh no, they don't walk. Or like they only walk with therapy. They, no, do not give them a walker. And it's just such like a clear cut, easy situation in which if we weren't there as the guardians of the walkers, you would see, it would be a very highly likely risk event for an adverse event such as a fall with a potential head strike. When they fall, it's not always pretty.

Speaker1:
[7:10] No, it always comes back like, who's at fault here?

Speaker0:
[7:13] Oh, God. Yeah. And everyone, when a bad thing happens, all the departments want to point fingers. So being able to just really clearly communicate your patient's needs and if there have been a change in their needs is really important so that we're all on the same page.

Speaker1:
[7:29] Yeah. An important aspect of knowing when to phone an interdisciplinary friend and communicate patient's needs has to do with both knowing your patient's baseline as well as knowing something when something is out of your scope of practice?

Speaker0:
[7:44] Yeah, definitely. We have a few different ways in which we can process information. And Emily, I think, had the right idea of starting off with just understanding how information works in your building. So why don't you tell us more about that?

Speaker1:
[7:57] So sometimes your build, I mean, everybody's building is different. So you really have to know how communication flows. Does your facility have those morning meetings where they're talking about generally what's going on? So a lot of times in those situations, they talk about specific events and they're like, is there any concerns? Then there also is a secondary meeting in my facility called UR, where they talk about the skilled people, the people who are looking to have a lot of changes so they can go more in-depth. But find out what communication systems you have in place. Are those the only two times that people are talking, or is there more on top of that? How are people communicating with one another, even within their own disciplines?

Speaker0:
[8:46] 100%. And then we got to really make sure we're collaborating with our heroes, the nurses. Nurses are just the central hubs of information and fostering strong communication with them is vital. Nurses are often the first point of contact for patient concerns, so keeping them informed is key. And to Emily's point about like UR meetings or stand up, whatever meetings you're having in your building, making sure nursing knows and also your DOR knows so that if they need to have a higher level discussion about it, that can happen at those meetings. Things that I try to really highlight with nursing are changes from baseline. So AMS or altered mental status, hematuria, blood in the urine, which we often see, well, it's easier to see with catheters. I haven't figured out how to seat in a diaper.

Speaker0:
[9:39] A sudden lethargy onset, you're really having a hard time rousing the patient, falls, someone is just even looking really wobbly. You're like, normally they're really good with their walker, but I saw them trying to get in and out of activities today and it was terrible. So just making sure that people are aware of those things, as we said with nursing. And also I try to make sure the rest of the rehab team knows because it becomes multiple reporting points. Like if I saw it in the morning and they see it in their afternoon session, now we kind of have a timeline of, oh, this has been going on from 9 a.m. to 3 p.m.

Speaker1:
[10:16] Yeah. And then we have to also make sure we're sharing information with other disciplines. So like you was just talking about like working with your other therapists, your physical therapist, on saying like, hey, in my therapy session, I know they are typically walking with a walker, but it looked super unsafe. They weren't doing any of those carryover strategies.

Speaker0:
[10:37] I'm so sorry I jumped the gun on the interdisciplinary one for rehab team.

Speaker1:
[10:42] That's okay. Because, I mean, it really... I mean, when we're talking about collaboration, we're talking about talking with people, it's hard not to have those times where there's overlap, because there is so much overlap in what we're doing and what the other disciplinary teams are doing. Like, looking in their briefs to see if there's blood in the urine. Like, I'm certainly not doing that, but maybe that happens with our occupational therapists when we're teaching toileting, and they are reteaching toileting.

Speaker0:
[11:17] Yeah. And to that point about redundancy, like when I see something weird happen in someone's room, I just go down the line. I like find the CNA and then I pass by the med cart and I tell that nurse. And then I walk all the way up to the nursing unit station. I tell the supervising nurse or the charge nurse. And then if she's in, I'll be like, hey, D-O-N, also you should know about this as well.

Speaker0:
[11:39] I'll just, I'll tell everyone, everyone I see, like, I'm ready to talk to everybody about this.

Speaker1:
[11:45] Yeah, but that's a lot of like a verbal communication and that probably takes a lot of time.

Speaker0:
[11:51] It does. It does. If only there was a way that we could have written communication to make sure that people had a reference point. Almost like an S bar.

Speaker1:
[12:03] Where you could write it down one time and then photocopy, send it out. So we, this is kind of skipping around, but we have made one for you.

Speaker0:
[12:13] It's true. We did.

Speaker1:
[12:14] We made an outline of the SBAR so that if something happens, link in the description. But so you can quickly write it down and utilize it at your facility. So it gives you the opportunity to, instead of running down the line, you can write it down, make a copy, give it to like one to your DOR, one to your DON, one to the unit. And then I would probably just talk to the CNAs so that they know that there's a change going on because their nurses are in charge of them to make sure they're doing what they're supposed to be doing.

Speaker0:
[12:49] A point that you've made pretty frequently is making sure that you have written documentation. One of the issues, as much as verbal communication can be just like, oh, I saw someone in the hall, I shouted out to them. A lot of times things don't like get done because there's so much happening in the facility. But having written documentation saying like on this date, this was provided to nursing essentially, you know, both as a referral process, but it also acts as like a part of the patient's now case file. It's like on this date, they started exhibiting falls or were not stimulable to being roused or it looked like they're getting wobbly, like maybe there's hypotension going on. And so making sure that there's documentation of these things is super important

Speaker0:
[13:34] for a patient's overall case history.

Speaker1:
[13:37] Yeah. We recently got someone in facility who came in on a Friday after I had already left, and it was a very complex case, a person coming in on a liquid diet, but an unclear liquid diet, a lot of vomiting, a lot of increased confusion. So in the documents that I read that were uploaded, it said patient is tolerating PO diet, however, doesn't like oatmeal, not they're like functioning okay, having conversations. And I go into this person so clear that they have had a stroke. The aphasia was severe, receptive and expressive, right-sided deficits, like all the line. And I'm like,

Speaker0:
[14:27] Just like a textbook example.

Speaker1:
[14:29] Textbook stroke. And I'm like, what, what is happening? Where is this information?

Speaker0:
[14:35] Oh, that's super unfortunate. You're saying it's like you went in, it was really obviously it had a stroke and there was nothing to have communicated that to you.

Speaker1:
[14:43] Nothing. So I'm like, did he have a, someone tell me, did he have a stroke? And they're like, oh, it doesn't say anything. My facility didn't even know. Like, so we had to get like more information. So I was able to write all of like in my evaluation, like my concerns in general and provide more in communication to my nurses to just let them know, like, this is what I'm concerned about. He did. This person went out and we're able to get more help for him. But it is essential to make sure like even the nurses coming in because he came in to us like that. So their hospital documentations weren't up to date. It was, it was just a big old, big old mess.

Speaker0:
[15:28] Yeah. A weird one that somebody did kind of an interdisciplinary referral to me for was, um, not talking. So it was likely a TIA or stroke, but the person didn't get sent out in time to find out. But one of the best CNAs I've ever met keeps like a little notepad with her. And whenever she would do her morning rounds, she would just kind of like to make a note about what she'd been seeing. And she eventually came up to and was like i've been telling other people nobody seems to be taking me seriously but my one of my patients has stopped talking and it's not like voluntary mutism stop talking like, isn't he's not making any sounds and he's trying and very similar situation like uh kind of, facial drooping on one side suddenly like onset of him uh weakness and was like oh he He probably did have a stroke, but it was just wild that it had been like three days and the only symptom that got communicated, and if this CNA hadn't been super persistent, would not have been followed up on, was he just wasn't talking. People were like, oh, he can talk. We know he can talk. He's just being quiet. No, apparently not. So that was, yeah, making sure we're all keeping each other in the loop is so important. But we digress. I think we have a list we have to get back to.

Speaker1:
[16:55] So when are things not our thing?

Speaker0:
[16:59] Yes. When you get pulled into the room and it's not a speech thing, tell people not our thing.

Speaker1:
[17:07] Oral abscesses or bleeding I cannot do anything about that You need to see Medical professionals Like a dentist or a doctor Why are they bleeding?

Speaker0:
[17:19] That's always my question Why are you bleeding?

Speaker1:
[17:20] I don't know I don't know how to fix that I cannot put a band-aid on your tooth It's not

Speaker0:
[17:27] A little gum band-aid Cute.

Speaker1:
[17:30] I'm sure someone can But not me I don't even know what that would look like Ask a dentist Ask Eva's mom

Speaker0:
[17:36] Ask my mom.

Speaker1:
[17:37] Difficulty managing secretions due to upper respiratory congestion. Eva, you explain this one.

Speaker0:
[17:44] I, in this last like six months, have seen so many secretion problems. It's crazy. Like people just coughing up this like viscous-y, foamy secretions. And sometimes it's been upper respiratory infection. Uh sometimes it has been um like pooling phlegm that got mixed in with saliva but it has just been a weird last six months in terms of the amount of people seemingly choking on their secretions and i always get called in because they're like oh this person is choking on their secretions i'm like yeah that's not like a oh they're struggling with saliva management which is more in our scope of things, this is them not being able to basically breathe because there is so much stuff in their throat. And they need to get suctioned. So I think one of the main things that I've begun communicating with is making sure I know who is in charge of suctioning in the building being like, this patient needs to get seen by that person. We don't have a formal training process. I keep trying to get trained in suctioning. But right now, that's still just under nursing purview.

Speaker0:
[18:58] And if you guys have any recommendations, please let us know on the best way to make that more of a speech available task. And two, if they are having a consistent problem where something in their body is now producing such heavy mucus that it's impeding their airway, they need to see a doctor. Like get that person out and seen by a physician. There's nothing that we're going to do with their regular meds or us as speech therapists. Like they need higher level help. Please send out for that.

Speaker1:
[19:35] When you're talking about suctioning, you're talking about trach people?

Speaker0:
[19:38] No, not trach people. So you can actually do suction tubes for just like orally and if necessary, like push it a little pharyngeally if it goes back down. The first time I was introduced for this was a woman who had had very severe stroke and she was a high aspiration risk. And the hospital protocol was bedside swallow withstand by suction. And so anytime they did bedside swallow with her, you just had like this oral suction situation going on because she most times wouldn't transit posteriorly and could not spit it out. So the only really effective way to thoroughly clean her mouth was with oral suctioning. Kind of like when you go to the dentist and they give you that little thing to suck on. But I have since seen ones that are more for managing secretions. I had a patient with COPD who had chronic phlegm. She was, capable of self-sectioning, was really comfortable with her own management. But if somebody has cognitive impairment or they're undergoing altered mental status because this is happening at the same time as like an infection of some kind, and they can't be in charge of their own suctioning or they're unable to tell you what's going on, we need to be treating what is causing the sudden onset of like high level mucus production.

Speaker1:
[21:02] Yeah. I didn't know you could suction pharyngeally from the oral cavity.

Speaker0:
[21:06] It's not pretty. It's not. It's no. Most of the time, you're not like shoving it back in their throat. It's usually primarily just oral. And you're trying to get them to like throat clear, cough up. Sorry, I made a hairball sound into the mic and get it that way. But we had recently this one guy who was just, it was like he couldn't breathe it was it was pretty bad so he got he got sent out later that day but they called me in for a speech referral and i was like this is not a swallowing issue, anymore like he did have swallowing problems at baseline but i was like, This has gone beyond food and water.

Speaker1:
[21:43] Were you able to do a fees on that person to make sure that it was all phlegm?

Speaker0:
[21:48] You know what? I can't remember what imaging he came back with.

Speaker1:
[21:54] Oh, okay.

Speaker0:
[21:55] Whoops. Sorry. I wish I could recall.

Speaker1:
[21:58] Not prepared for the follow-up questions. Yeah, I mean, for some of those patients, too, I'll mess with them to make sure if they're swallowing, if it is like, there's like a lot of mucus and they're like, oh, I always have mucus. I feel like that's always like someone's first complaint whenever they have swallowing stuff and they're just like, oh, it's mucus. But like, how do you know? Do you know it's mucus or are you guessing it's mucus because it kind of feels like mucus, like something is sticking back there, but really it's food or it is like saliva or maybe it is mucus and you need to do just like suck on some ice chips to help clear it down if you are allowed po

Speaker0:
[22:42] Yeah but he in this case he was not we did do a bedside swallow and he couldn't swallow around what was already in there and he would like cough up at these just giant ropey mucus clumps oh it was bad and he when he swallowed it like water came out his nose i was like there are lots of bad things happening here.

Speaker0:
[23:04] We got to get some clarity.

Speaker1:
[23:06] Yeah, that's too much.

Speaker0:
[23:08] Yeah, it was a lot. Anyways, back to those falls. When anyone has a fall, definitely report that to nursing and to your PTOT because that could be a change in gait status or functional standing status. But especially if there's a fall with head strike. If you see somebody fall and they hit their head or they have a cut on their head and they're like, oh yeah, I fell. It's like, well, did you smack your head on the dresser? Because you got a knot and like a zigzag cut like Frankenstein. What's going on there? But nursing also needs to do a fall assessment to make sure nothing was fractured or popped out of location. And that includes for head strikes, oral or facial fractures.

Speaker1:
[23:51] Yeah, if someone has something going on in their mouth and they're like, can they eat lunch now? Let's wait can we just like fix the problem before we're trying to rush a speech eval for food like this person is confused they probably have a concussion they probably don't want to eat right now anyways and now they got a tooth hanging straight out of their mouth like let's let's address the things that matter and then we'll start talking like get this person a sick tray to start. Just give him some soup and we'll talk about it tomorrow.

Speaker0:
[24:29] Yeah. And also on that line, vomiting. Getting called in for vomiting. If it's a one-off, then I don't know, maybe they're just sick. If it's happening repeatedly, that's not our specialty. That's GI. That's your doctor. And especially coffee grounds. I recently did an interdisciplinary referral for coffee grounds, which if you haven't come across it, is not real coffee grounds. It's what happens when there's blood in your GI tract or in your stomach and you vomit. It looks like coffee grounds, which is kind of weird to see. It turns out this guy had like a small, like abrasion, turned out to be fine, nothing serious. But we got that referral in, we ruled it out. And that's really important, is ruling things out. In fact, underrated is just making sure there isn't a serious problem and we can move on with the rest of the person's plan of care or course of treatment. And because I did report it, somebody else then reported the next one and that person had a jacked up GI bleed. So, you know, it turns out when we share, people share alike. And it's really important to make sure that we're all staying on the same page for our patients.

Speaker1:
[25:44] Yeah. And it's like that's so I feel like people say that to like, oh, they're they're vomiting like. Um, are they eating the right food? But like, so I mean, sometimes maybe, so I would go in there, but like, if it literally is people are vomiting, I can write up that eval. Like, this is what I think. These are my recommendations. And then, um, that gives people an opportunity to follow up on those recommendations. So we want to make sure that, um, part of the people following up is us. Like, even though I might see somebody for an eval only, that I'll be checking in with my DOR, especially if they're still on their caseload. Maybe they don't have a swallowing or cognitive issue, but they still need help walking and they'd help with their ADL. So they're in the team. So I'll take those opportunities to be like, hey, what's going on? Was this able to happen? They're like, oh, I think nursing is doing that or going back to nursing, just writing them love notes and saying, what's happening? I miss you.

Speaker0:
[26:48] What's happening, nursing? Miss you. How's 2-12-A bed? And also just really quickly on that vomiting, we had a PEG-2 patient with PO orders. She didn't like to eat a lot. And she started chronically vomiting. And just with a lot of back and forth communication with nursing, we kind of determined that maybe she was getting bolus overload. And so we worked with the dietician to change the timing of her peg so that she wasn't, she was getting push bolus, not continuous. We're like, I don't know, maybe her stomach's getting overloaded between meals and that's causing vomiting. She eventually got sent out for something more serious happening, but that was a really daily follow-up situation. Like, what's the vomit status on 200 beds? And making sure that we are following up until it has been resolved as far as we can tell. You know, not necessarily that

Speaker0:
[27:51] the issue has gone away, but that it has reached the appropriate party.

Speaker1:
[27:55] So we wanted to provide you just some practical tips to help with your communication. I talked a little bit about the SBAR we made for you to use. But you should also develop a communication guide in your building. Like how is communication flowing? We talked about this too. Like how do your nurses communicate with one another? How do you communicate in your therapy team? Where do they like information to go to?

Speaker0:
[28:25] A hundred percent. And the amount of times that people are filling roles in the building just to the best of their ability and they don't actually know where the information goes. You know, once you find out, write it down, let people know and be like, okay, if we see this incident again, it has to follow this chain of command because then you're also helping other people with their communication in the building. So communication guide, highly recommend it.

Speaker1:
[28:49] We also want to continue to educate, right? Or educating nursing about downgrades and advancement and their notes. I put a lot of stuff in my emails or my progress notes or my discharges. And like those things go to insurance companies, but very rarely is nursing reading what I'm writing. So providing them an opportunity, sometimes I'll like outside of the S bar, if I'm following up on something or I have carbon copy notebooks and I'll write one down, make a photocopy. I keep one. The copy goes to the DON, my DOR. So everybody's on the same page. About like what's happening, why like a discharge is coming up with my progress note, what my recommendations are generally, just a little recap of important highlights in my documentation that they're not going to read.

Speaker0:
[29:49] Yeah. And kind of to touch on this and the communication guide, like I'll put that the person needs a one-to-one feed recommendation in my eval and then it doesn't happen. And so at different buildings I've worked at, I have to go, okay, how do we know if somebody needs a one-to-one feed or a distance supervision? And then being like, oh, okay, so my eval triggers no documentation. I have to go put it in the EMR or I need to go talk to nursing. Or sometimes I've talked to medical records and they're the person who's in charge of printing the daily list for who needs a feeding assistance. Like really it is up to us to find out that information and making sure it's getting treated appropriately um because otherwise but you know, Patient care is just not getting done.

Speaker1:
[30:34] We need it. That's all we care about is that what we're doing is meaningful. We're having an impact.

Speaker0:
[30:40] I think we've touched on everything we want to talk about, Emily. I think it's time to wrap up.

Speaker1:
[30:44] Yeah. So to wrap this one up in a pretty little bow, fostering open communication and collaboration, we can create more effective healthcare environment for our patients. So our teamwork, we're making the dream work.

Speaker0:
[30:59] Yeah. especially when that dream work is improved patient outcomes.

Speaker1:
[31:03] Again, and I said this, I keep repeating myself whether I said this already, but I've said this already. We made some stuff for you. We did a SBAR page, but we also made an in-service. If your facility is like, what's SBAR? Why is this important? You're like, hey, here's why it's important. I really want to talk to you more. So if you find my love notes around, And this is why I'm giving you love notes.

Speaker0:
[31:31] And when you use our SBAR communication in service or tools, please refer to it as Emily's Love Notes. We're really trying to get that started as a thing. All right, you guys, it's been a great talk.

Speaker1:
[31:41] Bye.

Speaker0:
[31:42] Bye.

Speaker1:
[31:44] You've been listening to Speech Talk.

Speaker0:
[31:46] Thank you, everyone, for coming to listen to our research book club. Until next time, keep learning and leading with research.

Speaker1:
[31:52] If you like this episode and you want to give us some love, please rate us on your favorite podcasting app. Leave a review and tell the world, because as podcasters, our love language is in positive affirmations.

Speaker0:
[32:04] If you have a research topic you want us to cover, or you have episode comments, clinical experience you want to share, or just want to send us some love letters, send us an email at hello at speechtalkpod.com.

Speaker1:
[32:17] If you want even more Speech Talk content, check out our website at speechtalkpod.com, where you can find all of our resources we made for you, copies of articles covered, and Eva's blog following these topics and more.

Speaker0:
[32:30] We're your hosts, Eva Johnson and Emily Brady.

Speaker1:
[32:33] Our editor and engineer is Andrew Sims.

Speaker0:
[32:36] Our music is by Omar Benzvi.

Speaker1:
[32:38] Our executive producers are Aaron Corney, Rob Goldman, and Shanti Brooke.

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[32:42] To learn about Speech Talk's program disclaimer and ethics policy, verification and licensing terms, and HIPAA release terms, you can go to speechtalkpod.com slash disclaimers.

Speaker1:
[32:54] Speech Talk is a proud member of the Human Content Podcast Network.

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[33:01] Music