Speech Pathology Australia Risk Assessment Tool (COVID-19)*

The Speech Pathology Australia-Risk Assessment Tool (COVID-19) [SPA-RAT (COVID-19)] is designed to assist speech pathologists assess the number and type of risk factors for transmission of COVID-19 that may be present in any “in person” clinical scenario.

The tool supports speech pathologists in making a decision about whether they see their client/consumer in the context they have described.

It is not a decision-making tool.

Information used in this this tool comes from many sources and, given the constantly emerging knowledge base regarding COVID-19, will be revised and updated as new information and recommendations become available.

The tool takes approximately 10 minutes to complete. Upon completion of the SPA-RAT (COVID -19), the speech pathologist will be emailed a report listing the risks identified in this tool along with recommendations for risk management.

Members should check their junk email box if it has not arrived after 10 minutes.

Use the Speech Pathology Australia Risk Assessment Tool (COVID-19).

Watch the video

It is recommended that speech pathologists completing the tool for the first time view the associated video clip to learn more about the development of the tool and the guidance and recommendations that will be received to identify and manage risk related to individual circumstances.

This is a screen shot of the video that accompanies the Speech Pathology Australia Risk Assessment Tool
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Use the Speech Pathology Australia Risk Assessment Tool (COVID-19).

Help

Questions regarding the use of the tool should be emailed to Speech Pathology Australia.

Advisory Panel

The development of this tool has been informed by an Advisory Panel, recently convened to assist the Association and to provide guidance for speech pathologists during the COVID-19 pandemic. The panel includes representatives working across a range of clinical areas and practice settings. The Association thanks the members of the advisory panel involved in the development of this tool, in particular Associate Professor Cate Madill, Gaenor Dixon, Dr Emma McLaughlin, Professor Liz Ward and Dr Kelly Weir.

Speech Pathology Australia Risk Assessment Tool (COVID-19) risk factors: general guidance

Risk

Considerations

Written Guidelines/evidence

Clinician factors

‘Yes’ response to any of the COVID-19 screening questions

Do not continue to work , seek medical advice and/or COVID testing. Stop providing face to face speech pathology interventions until you have been cleared to return to work

Department of Health COVID-19 online symptom checker

Speech pathologist’s age >70 years or 65 years with chronic medical conditions (>50 for Aboriginal Torres Strait Islander speech pathologist)

Increased risk of more serious illness as defined by the Department of Health in older age groups.

Department of Health Advice for Aboriginal and Torres Strait Islander peoples and remote communities

Department of Health advice for older people

Safework Australia Vulnerable Workers

Health - speech pathologist has increased risk of more serious illness as defined by the Department of Health due to health condition

Consider personal circumstances and health risks

Department of Health Advice for People with Chronic Health Conditions

Safework Australia Vulnerable Workers

Working across multiple clinical sites in one day

Potential increased risk of exposure for community transmission of COVID-19 (clinician and client/others), consider scheduling to reduce potential exposure

SPA Guidance for Service Delivery

Seeing 10+ clients /day

The more clients seen, the higher the potential exposure to community transmission.

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Providing home visits

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Providing sessions in highly populated environments e.g. schools

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA guidance on returning to work

SPA Guidance for Service Delivery

Providing services to residential facilities, e.g. aged care, group home

Residents experience increased vulnerability to COVID-19.

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Department of Health advice for older people

Department of Health Advice for People with Chronic Health Conditions

Safework Australia Working in aged care

Providing services to COVID-19 patients, or "At Risk" wards or sites (e.g. a residential and aged care facility with known COVID-19 history)

Increased risk of transmission of COVID-19, consider local health authority guidance and organisation policies/procedures, modifications to speech pathology procedures and additional precautions as per SPA guidance

SPA Guidance for Service Delivery

Members of household residing over multiple residences

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g  live or work where there is elevated risk of local transmission of COVID-19). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Lives or work where there is elevated risk of local transmission of COVID-19 (see state based health departments for details)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. age). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

COVID-19: Geographically localised areas with elevated risk of community transmission

Transport : public transport/car pool/taxi/uber

Potential increased risk of exposure for community transmission of COVID-19 (clinician and client/others), consider alternatives or scheduling to reduce potential exposure.

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Infection prevention and control considerations (personal and environmental)

Access to hand washing / sanitiser

Regular hand cleansing is required to reduce risk of transmission. Consider how to source appropriate resources and how appropriate hygiene will be maintained

Department of Health advice for hygiene and cleaning

Safework Australia Health, hygiene & facilities checklist

Completion of infection control training provided by facility or self-sourced if private practice (e.g.., https://www.health.gov.au/resources/apps-and-tools/covid-19-infection-control-training)

Identify and complete appropriate training required for workplace. Complete organisation training if available, discuss appropriate training with employer

Department of Health online infection control training

Access to recommended PPE for task (See SPA's Guidance for service delivery document for details)

Identify what PPE is recommended for a particular task/intervention, described in the SPA guidance and Health Department advice. (Coming soon: Speech pathology infection prevention and prevention protocol)

SPA Guidance for Service Delivery

Department of Health advice for health and aged care sector

Department of Health PPE for the health workforce

Safework Australia: PPE and the early childhood sector

Completion of PPE training as provided by facility or self-sourced if private practice

Identify and complete appropriate training required for workplace. Complete organisation training if available, discuss appropriate training with employer

Department of Health wearing PPE

Access to surgical masks through PHNs

NSW Centre for Clinical Excellence PPE training videos

Clinician control of environment, ability to set up environment? e.g. maintain physical distancing or separate treatment area

Consider ability to control environment, modifications to interventions as per SPA guidance, can standard precautions be undertaken), can intervention be modified

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Ability to appropriately disinfect equipment used in task

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken).

Consider using alternative equipment, single use equipment, can standard precautions be undertaken), can intervention be modified

SPA Guidance for Service Delivery

Safework Australia How to Clean and Disinfect your Workplace

Department of Health advice for hygiene and cleaning

Ability for sufficient time between clients for cleaning or to alternate consulting rooms between clients

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Safework Australia How to Clean and Disinfect your Workplace

Department of Health advice for hygiene and cleaning

Ability to maintain recommended social distancing in the work environment many include spacing of office chairs, staff desks, erected barriers, etc.)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Safework Australia: physical distancing and early childhood sector

Able to maintain lunch/staff area separate to treatment areas

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Safework Australia How to Clean and Disinfect your Workplace

Department of Health advice for hygiene and cleaning

Scheduling can be staggered to allow for cleaning (client appointments, staff lunch)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Safework Australia How to Clean and Disinfect your Workplace

Department of Health advice for hygiene and cleaning

Other staff, people present adherence to physical distancing recommendations

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Environment cannot be disinfected appropriately (e.g. hard surfaces)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Safework Australia How to Clean and Disinfect your Workplace

Department of Health advice for hygiene and cleaning

Client/Consumer Factors

Yes response to any standard COVID Screening Questions

Increased risk of transmission, consider local health authority guidance and organisation policies/procedures, modifications to speech pathology procedures and additional precautions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health COVID-19 online symptom checker

Client not asked COVID Screening Questions

Ask questions prior to service delivery, consider routine inclusion of questions in client contact prior to session

SPA Guidance for Service Delivery

Department of Health COVID-19 online symptom checker

Client age >70 years or 65 years with chronic medical conditions (>50 for Aboriginal Torres Strait Islander client)

Increased risk of more serious illness as defined by the Department of Health in older age groups

Department of Health Advice for Aboriginal and Torres Strait Islander peoples and remote communities

Department of Health advice for older people

Health- client has chronic health conditions

Chronic health conditions may increase risk of more serious illness as defined by the Department of Health consider modifications that may need to be made, modification to procedures, interventions provided, length of session

Department of Health Advice for People with Chronic Health Conditions

SPA Guidance for Service Delivery

Health status not known

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Ability to control behavioural regulation (poor behavioural regulation may lead to issues with increased shouting, saliva control, which increased AGP risk)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Client contact with adults - Daily close contact with 10 adults or more

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Safework Australia: physical distancing and early childhood sector

Involvement of other services. Does the client receive in person services from organisations other than yours which increase contact with other adults.

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Members of client's household residing over multiple residences.

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Lives or works where there is elevated risk of local transmission of COVID-19 (see state based health departments for details)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Requires presence of carer some/all of the time, in close proximity (less than 1.5 metres)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Client catches public transport, car pool, taxi, Uber

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Length of Interaction 15 minutes or less, 15 minutes, - 2 hours, 2 hours or more

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Proximity to client at any time of service delivery less than 1.5 metres

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster, can standard precautions be undertaken)

SPA Guidance for Service Delivery

Department of Health advice on physical distancing

Safework Australia: physical distancing and early childhood sector

Orientation to client facing client all of the time

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Task (undertaken by clinician or others) = Aerosol Generating Procedure, or potential to trigger an increase of aerosol particles (e.g., loud phonation; loud coughing)

Consider in context of service delivery, including age of client, intervention/procedure being undertaken, cohort risk (e.g. located in COVID-19 cluster). Consider modifications to interventions as per SPA guidance

SPA Guidance for Service Delivery

Department of Health advice to protect yourself and others

Department of Health advice on physical distancing

 

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