DGR 7 - July 2017

DGR 7 - July 2017

$15.00

Total Duration: 52:46

Video: 1

Dysphagia Grand Rounds 7

Article: Omission of Dysphagia Therapies in Hospital Discharge Communications
Authors: Amy Kind, Paul Anderson, Jacqueline Hind, Joanne Robbins, and Maureen Smith
Journal: Dysphagia. 2011;26(1):49-61.

Download DGR 7 article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888892/

Abstract:

Background
Despite the wide implementation of dysphagia therapies, it is unclear whether these therapies are successfully communicated beyond the inpatient setting.

Objective
To examine the rate of dysphagia recommendation omissions in hospital discharge summaries for high-risk sub-acute care (i.e., skilled nursing facility, rehabilitation, long-term care) populations.

Design
Retrospective cohort study

Subjects
All stroke and hip fracture patients billed for inpatient dysphagia evaluations by speech-language pathologists (SLPs) and discharged to sub-acute care in 2003-2005 from a single large academic medical center (N=187).

Measurements
Dysphagia recommendations from final SLP hospital notes and from hospital (physician) discharge summaries were abstracted, coded, and compared for each patient. Recommendation categories included: dietary (food and liquid), postural/compensatory techniques (e.g., chin-tuck), rehabilitation (e.g., exercise), meal pacing (e.g., small bites), medication delivery (e.g., crush pills), and provider/supervision (e.g., 1-to-1 assist).

Results
45% of discharge summaries omitted all SLP dysphagia recommendations. 47%(88/186) of patients with SLP dietary recommendations, 82%(93/114) with postural, 100%(16/16) with rehabilitation, 90%(69/77) with meal pacing, 95%(21/22) with medication, and 79%(96/122) with provider/supervision recommendations had these recommendations completely omitted from their discharge summaries.

Conclusions
Discharge summaries omitted all categories of SLP recommendations at notably high rates. Improved post-hospital communication strategies are needed for discharges to sub-acute care.

Includes
52:46
DGR 7: Omission of Dysphagia Therapies in Hospital Discharge Communications | July 2017

In this webinar, Dr. Ianessa Humbert reviews a retrospective cohort study, investigating the rate of dysphagia recommendation omissions in hospital discharge summaries for high-risk subacute care patients. SLP Rinki Varindani Desai discusses the clinical implications of this study at the end; discussing potential solutions to improve dysphagia documentation and communication hand-off to improve patient care.