Measuring Outcomes for Success…..What are You Using?
I have written about the Dysphagia Toolbox before, but I am planning on doing it again! This site just simply can’t get enough recognition as far as I’m concerned!
The one thing I can’t help thinking is why we call it a toolbox. Do most of you actually carry a toolbox full of your must-have dysphagia assessment/treatment equipment? Mine is usually jammed in my lab coat pockets or on top of my clipboard, if I remember to even bring that with me!
Maybe saying our dysphagia “apron” would be more appropriate??
Anway, I digress…
There are several outcome measures that are freely available for us to use from the Dysphagia Toolbox. There are questionnaires that the patient completes, indicating current symptoms when eating/drinking including:
Eating Assessment Tool-10 which has 10 areas where the patient rates their swallowing.
The Sydney Swallow Questionnaire has 17 areas that the patient rates from rarely to always by placing an “x” on a line drawn for them.
Clinicians may use:
The Functional Oral Intake Scale (FOIS) where they rate the patient’s diet level on a scale from 1-7, with a description of each diet provided.
The FOIS is actually much the same as the ASHA NOMS, which can be used to give a numeric patient rating by the diet they are currently consuming.
The Penetration Aspiration Scale gives numbers regarding how deep penetration/aspiration occurs and if it was cleared or not.
The Modified Barium Swallow Impairment Profile is a standardized means to modifieds with rating scores given to each of 17 physiological events during swallows of multiple consistencies. Training is required to become a registered user of the MBSImP.
The Mann Assessment of Swallowing Ability (MASA) is completed the the SLP as they complete a bedside or clinical swallow evaluation. This gives a numeric score (up to 200) and provides a rating scale (mild, moderate severe) for both dysphagia and aspiration. The MASA is also available in a version for patients with cancer called the MASA-C.
This is a small list of some of the outcome measures available to us. You want to look for measures that are both valid and reliable. Outcomes give us a way to measure progress by stating where the patient began and ended therapy. It is crucial in this day and age with Medicare to measure your outcomes in a clear and precise manner.