Managing Dysphagia Risk Could Reduce Repeat Hospital Admission Rates By 65%!

Repeat hospital admissions is a growing problem in America and around the globe. Nearly 1 in 5 aging adults will be admitted to the hospital, this year. Older age, by itself, can predispose someone to being admitted to the hospital. Combined with other factors such as race, gender and health insurance policy type, 30 day return to hospital admission rates can go up (Silverstein et al., 2008).

Out of every 5 adults that are admitted into the long term care setting, consisting of skilled nursing facilities (SNF), assisted living facilities (ALF), independent living facilities (ILF), 2 or 3 of those adults will fatally return to the hospital within 12 months. In those 12 months, the patients continue to decline, return to the hospital multiple times where the times between hospitalizations gets shorter and the hospital stays get longer (Lum et al., 2012; O'Malley, Caudry & Grabowski, 2011).

This growing evidence prompted the Department of Health and Human Service's Center for Medicare Services (CMS) to emphasize care that reduce repeat hospital admission rates. They instructed clinicians to continue to provide comprehensive care to their patients, and in return CMS would expand the payment system to better address the needs of those conditions that can effectively reduce repeat hospital admission rates.

Aspiration pneumonia is a condition where an individual's food and liquid is going into their lungs due to a breakdown in their swallow. Over time, this can result in pneumonia. Aspiration and aspiration pneumonia have been linked to repeat hospital admission rates, and in 2011, CMS emphasized reducing aspiration risks in their patients.

The functional assessment and management of the swallow is possible through use of the Dysphagia System Test (DST). The DST observes the swallow as the patients eats their own food, at their bedside, in their dining setting or in the outpatient setting. Real color video is able to observe the swallow, and a skilled Speech Language Pathologist is able to see what is going on and determine the appropriate course of action.

Dysphagia Management Systems LLC (DMS LLC) was poised to be on the forefront of reducing repeat hospital admissions in 2011, because of the relationship to dysphagia (e.g. a breakdown in the functional swallow) and aspiration (e.g. food/liquid entering the lungs when it shouldn't).

For 27 years, DMS LLC has been providing comprehensive dysphagia evaluations utilizing the Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in the aging community.

An accurate diagnosis is essential for effective dysphagia management. Our state-of-the-art DST is the only technique that evaluates all five bodily systems required for safe swallowing: Muscular, Neurological, Respiratory, Gastrointestinal and Cognitive (see photo above!).

DMS LLC considers the function of each system individually and establish the patient’s risk of complications from the dysphagia as a whole. Knowing what is causing the dysphagia helps us to identify the most effective approach to treatment. We begin with a thorough review of the patient’s medical history. One of our clinically privileged Speech Language Pathologists will talk in depth with the patient, family, nurse and facility Speech Language Pathologist about the patient's medical conditions and symptoms.

Our Speech Language Pathologist performs the DST and after reviewing the results with the patient and his or her Care Team, DMS LLC provides recommendations for diet, therapy and further evaluations. Our Speech Language Pathology Specialists also train the facility's staff to be prepared for the most efficient identification of dysphagia, from admissions through discharge. This approach has been shown to improve patient outcomes and reduce repeat hospitalizations and repeat medical complications.

In 2019, CMS announced additional initiatives to reduce repeat hospital admission rates through the management of the swallow and other factors related to its breakdown such as cognitive impairment. Now, Speech Language Pathologists will be even more prepared to possibly reduce repeat hospital admission rates through effective dysphagia management.

Utilizing a technique like FEES as opposed to the Modified Barium Swallow (MBS) could be beneficial in the treatment of dysphagia as many dysphagia factors predictive of aspiration and aspiration pneumonia are not visible through X-ray technology. For example, secretions and gastroesophageal reflux (GER)/blackflow are not coated by barium and thus, invisible with the MBS. The DST incorporates FEES technology into its comprehensive evaluations and through a color video image, is able to see a broader range of dysphagia signs and symptoms that could help predict aspiration risk and/or repeat hospital admission risk. In fact, 82% of patients who receive any of instrumentation, such as FEES, are less likely to go back to the hospital because their dysphagia could be managed appropriately (Croghan et al., 1994; Rofes et al., 2010).

Independently, DMS LLC has conducted its own internal research and confirmed that more than 60% of patients who receive the comprehensive DST with FEES saw a reduction in signs and symptoms of dysphagia and their risk of aspiration/repeat hospital admission rates!

Find out how you can learn more about bringing the DST with FEES to your building!

Call 855-693-7822 or go to dysphagiamanagement.com to get connected with us, today!