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Czechoslovakia
Projekt
“European Centre for Communication Disorders”
Introduction
Roughly 540 million people the world over (in Europe 64 million)
suffer from serious communicative disorders and difficulties.
In all cases, they affect the economic and social status of the
patient and his/her family. Delayted treatment unnecessarily increases
medical as well as social welfare costs.
On a global scale, it is the International Association of Logopedics
and Phoniatrics (IALP), in Europe it is the Union of European
Phoniatricians which strives to improve the present situation.
The historical development and economic situation in individual
continents and countries is reflected in the significant differences
in the concepts, development and provision of care to patients
with communication disorders.
In this complex activity we are lacking the opportunity to compare
out-patient practices relating to individual concepts in different
countries. Therefore we recommend to establish Centres for Communication
Disorders in different continents or in other specified regions,
which would be helpful in this respect. The Centres would allow
the targeted choice and modeling of therapeutic and prophylactic
procedures and methods and selection of the most suitable program
for a given area.
The present organizational structure of providing out-patient
curative and preventative care to patients with communication
disorders clearly demonstrates the requirements for further development.
To make it more effective and efficient, it has to be oriented
systematically towards achieving comprehensive screening programs,
early diagnostics and treatment by teams of specialists of various
professions - phoniatrics, logopedics, speech language therapists,
psychologists and engineers - based on well-equipped and well-staffed
diagnostic and therapeutical centres. Such centres - either public,
attached to teaching hospitals or privately run, should provide
diagnostic and therapeutic expert services to patients and their
families and advise specialists throughout the country. They should
develop in close collaboration between health, educational and
social authorities and establish conditions for pre-graduate and
graduate training of specialists. In view of the nature of communication
disorders and hearing defects and their different nature from
other disorders, treatment in day-care centres or boarding-hostels
appears more suitable than a hospital environment.
Purpose
and Object of Project
Purpose of the Project is to establish European Centre for Communication
Disorders to compare out-patient practices in Europe related to
individual concepts in different continents and regions, the assessment
of professional and economic results.
The Centre should be a model for procedures in the professional,
organizational and economic sphere and for initiating out-patient
treatment prior to its application in general practice: 1) experts,
organizational and economic activities, 2) cooperation of experts
with patients and their families, 3) providing combined medical,
nonmedical, social and educational care, 4) compiling statistical
data, 5) setting up information systems. The Centre will participate
in the pre-graduate and graduate training of experts, also from
other countries (underserved areas) and in research especially
in clinical areas related for example, to improved out-patient
management of communication disorders. The objective of the Project
is to improve treatment of patients with communication disorders
whilst minimizing the costs of such treatment on a world- scale.
The European Centre will have to be well equipped with contemporary
technology and to be well staffed and housed in premises warranting
its development.
The centre is to be an independent, autonomous, non-profit health
facility, funded from multiple sources.
Main
Tasks of European Centre
I. model:
a) activities:
- curative and preventive,
- organizational
- economic - linked to the given health service
b)
collaboration of specialists with patient and his/her family
c) ensuring comprehensive care
- medical, non-medical, social, educational
d) other.
II.
Collect statistical data and build up information systems
III.
help train its own specialists and experts from abroad
IV.
develop research in clinical practice
Specific
Tasks in the host country:
All activities shall be targeted to develop care for interpersonal
communication in Europe, coordinated with international professional
organizations, primarily with the Union of European Phoniatricians.
Significance
of Project, expected effect:
It
is a Project for the future, because it is based on screening
the population, early diagnosis and therapy of communication disorders
carried out by specialists in related fields in cooperation with
patients and their families. It would form a basis for the development
of preventive, diagnostic and therapeutic care for the younger
generation and for adults on Europe-wide scale. It will improve
health care for the citizens, giving them access to the latest
diagnostic and curative procedures carried out according to up-to-date
principles. National and foreign specialists will be involved
in the Project. The practical application of the results of the
Project is safeguarded by the participation of the Union of Eurepean
Phoniatricians.
Funding of the Project:
- health insurance fees for curative and preventive treatment
provided by Centre
- government subsidies
- contributions from international organizations and funds (exx.
PHARE, Czech-German Future Fund etc.)
- private donations via the Foundation Fund for Developing the
Care for Voice, Speech and Hearing
- contributions from the municipality
- contributions from the graduate training of specialists
- research grants
Proposal:
Currently
there is a suitable opportunity to establish the European Centre
for Communication Disorders in Czech Republic. Therefore we recommend
to set the Centre in Prague. The cooperation with a simillar Centre
in USA could be allowing a comparison of the American concept
with that European of the Berlin - Prague - Wiena phoniatric school
which has been applied in a number of European countries.
In the Czech Republic, more than 750.000 persons, among them 350.000
children, suffer from communication disorders.
Phoniatrics and logopedics have a long tradition in the Czech
Republic thanks to their founders Professor Seeman and Professor
Sovák. Phoniatrics was established in the Czech Republic
in 1922. The Prague school of phoniatrics taught, and still teaches,
that the care for patients with disorders of voice, speech and
hearing defects forms an inseparable unit. It is based on preventive
care (health screening), early diagnosis and the treatment of
children and adults. It is carried out by a team of medical and
non-medical experts in related fields, in co-operation with the
patient and his family. The care is provided in close collaboration
with health servise, social and educational authorities.
Patients are for the most part treated on an out-patient basis
(approx. 90%) and this should be undertaken in local phoniatric,
logopedic (speech therapy) and psychology out - patient surgery,
as close as possible to the home of the patient. On January 1,
2000, the Czech Republic had 79 phoniatricians and 289 clinical
logopedists (speech language therapists). Early diagnoses and
treatment require, apart from the team-work of specialists, also
high-quality, up-to-date technology . Such facilities, however,
are unevenly distributed.
Specific
Tasks of the Europe Centre in Prague:
- to develop prevention, early diagnostics and treatment of communication
disorders in collaboration with the patients family, with health,
social and educational authorities and the media,
- to develop cooperation with specialists in regions and offer
them the use of its special diagnostic, curative rehabilitative,
prosthetic, consulting, expert, information and other services.
- to develop novel diagnostic and therapeutic methods for out-patient
care
- to address special problems of auditory prosthetics and comprehensive
rehabilitation for paediatric patients living outside Prague,
- to provide barrier-free access,
- to develop care for voice professionals and musicians playing
wind instruments,
- to develop care for patients of ethnic minorities in their mother-tongue,
- to set up an information centre, that will provide professional
and organizational information to general practitioners, specialists,
patients and their families,
- to set up a central register of children with hearing defects
(in future also of children with other communication disorders),
in connection also with similar projects developed in countries
of the EU),
- to create a model institution for this field, facilitating the
verification of new diagnostic and curative methods, as well as
organizational and economic approaches prior to their nationwide
application in practice,
- to provide a framework for applied research funded by grants
and carried out in cooperation with the relevant institutions,
clinics, institutes, universities and professional societies in
the Czech Republic and abroad, facilitating the participation
of young specialists including foreign nationals,
- to participate in the pregraduate and graduate training of specialists
with a view to developing out-patient care,
- to cooperate with social and educational authorities,
- to promote international professional collaboration in order
to apply proven international procedures in the Czech Republic,
- to establish organizational, economic and working conditions
ensuring continued development of the Centre and its economic
autonomy.
Organization Responsible for Project Implementation:
Name and nature of organization: MEDICAL HEALTHCOM Ltd., Centre
for Communication Disorders
Address: Resovská 10/491, Prague 8 Postal Code: 181 00
Telephone: 00420-2-854 33 85 Fax: 00420-2-855 03 39
Director: Associate professor Frantisek Sram, M.D.
Address: Resovská 10/491, Prague 8 Postal Code: 181 00
Description
of Organization
The European Centre should be established by reconstructing the
pavilions of the existing Centre for Communication Disorders,
Medical Healthcom, Ltd., Cechovská 10/ 491, 181 00 PRAGUE
8. Its built-over area comprises 1.109 sq.metres, the entire lot
has 5.215 sq.metres and is located in a quiet part of the Bohnice
Housing Estate on the outskirts of Prague. The Centre is easily
accessible by city bus from the final subway stop “Holesovice”.
The
Centre for Communication Disorders, Medical Healthcom, Ltd was
founded in 1991 with the assistance of the Good Will Committee
of Mrs. Olga Havlová, as seat of the Sub-Chair of Phoniatrics
and Audiology of the Postgraduate Medical Institute (providing
training for phoniatricians, clinical logopedists, speech and
language therapists in the Czech Republic) as well as providing
the Phoniatrics Department of the Municipal Health Clinic of Prague
8, with day-care for children with hearing defects and voice and
speech disorders. Since 1995, it has been run as a private health
facility (Co.Ltd.). Establishing the centre enabled the full implementation
of the Prague phoniatric schools philosophy on the out-patient
care - i.e. comprehensive early screening; early diagnosis and
treatment by multidisciplinary teams of specialists from related
fields of expertise; development of the pregraduate and graduate
training of specialists, as well as research into novel diagnostic
methods suitable for out-patient care. The Centre serves the whole
country and cooperates with institutions abroad.
Since 1992, the Centre has been treating roughly 9-11.000 patients/year
with voice and speech, language disorders and hearing defects.
The
Projects envisages doubling the floorspace of the Centre, providing
a barrier-free area for the physically handicapped, enlarging
the capacity of the out-patient wards by an out-patient department
for specialists in related fields, increasing the capacity of
the day-care centre for children with communication disorders
and hearing defects to 35 places, setting up a boarding-house
for mother and child, in order to make the Centres services accessible
to all.
Two
architectonic studies for the reconstruction of the Centre for
Communication Disorders, Medical Healthcom, Ltd. were designed.
Planned Implementation:
Duration of Project: 2000
Expected completion: 2001
Ideal start-up date of operation: 2000 at the time of the Abilympics
World Conference in Prague (expected attendance 5000 specialists).
2001 - 25th Congress of International Association of Logopedics
and Phoniatrics, Montreal, Canada - Information to be given on
founding and activities of Centre,
2002 - 80th anniversary of founding Czech phoniatrics - demonstration
of first results of activities
2004 - 26th Congress of International Association of Logopedics
and Phoniatrics, Brisbane, Australia - Report on Centres activities
and comparison of results of European philosophies of care for
patients with communication disorders.
Prague
8. 2. 2000 Ass. Prof. Dr. med. Franticek SRAM, CSc.
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