Mrs Anneliese Wegener1, Ms Nicolette Varvounis1, Ms Jana Havlis
1Northern Adelaide Local Health Network, Australia
Biography:
Jana Havlis is a senior speech pathologist at Lyell McEwin Hospital, Northern Adelaide Local Health Network. She has over 10 years experience in adult acute dysphagia and communication disorders. More recently has gained experience with managing communication disorders and dysphagia with consumers within older persons mental health and forensic health.
Abstract:
Speech Pathologists within NALHN conduct Videofluoroscopic Swallowing Studies (VFSS) to objectively assess and manage swallowing impairments (dysphagia). Noting variances in practice, concerns were raised regarding patient exposure to unnecessary radiation, over-diagnosis of dysphagia, and lengthy reporting timeframes. A project was initiated to standardise procedures, improve inter-rater reliability, and enhance report efficiency and accuracy, based on current evidence.
The project involved benchmarking against other local and interstate health networks, a literature review for evidence-based recommendations, and simplifying and reorganising the VFSS report for improved usability and interpretation of test outcomes and recommendations. A guideline was implemented to standardise patient trials during VFSS, ensuring consistency and appropriate information capture. Additionally, a new VFSS rating tool was introduced, providing clear evidence-based criteria for determining ‘normal’, ‘functional’ or ‘impaired’ swallowing parameters
Following project implementation, NALHN clinicians trialled the new procedures, report, and VFSS rating tool. Results showed improved consistency and accuracy in reporting and diagnosis of dysphagia. Clinicians undergoing VFSS training also reported improved clarity of processes and confidence in skill development.
While the literature review highlighted the need for standardised practices in VFSS, it revealed a significant gap in established protocols for comprehensive patient assessments. This project’s innovative approach in developing and implementing consistent minimum standards for VFSS trials represents a first step in addressing this knowledge gap and improving clinical practice. A future project aims to establish a comprehensive, evidence-based guideline for VFSS procedures.