Dysphagia Supervision Initiative
Project Developer & Manager
A pilot program turned into a hospital-wide initiative
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Patients in a rehabilitation hospital often present with swallowing difficulty and/or cognitive challenges that impact their safety while eating and drinking meals.
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Speech-language pathologists assess and make recommendations for "supervision" from staff to be implemented for patients, however this results in increased workload for staff which decreases adherence to recommendations.
The
Problem
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Explore efficacy of a new design to signage and orders to improve adherence to meal time supervision for patients with appropriate staff oversight
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Goals were:
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Improved staff confidence and understanding of recommendations
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Improved adherence to recommendations
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Decreased staff workload burden
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The
Project
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Audits of the number of patients on meal-time supervision recommendations
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Audits of adherence/implementation of recommendations during meals​​
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Pre- and Post-surveys regarding perceived burden of care and confidence in understanding the recommendations
Key Performance Indicators
The Results
The yellow line indicates pre-pilot data collection of how often staff were adhering to recommendations and providing appropriate meal-time supervision. The orange line indicates the same data points that were collected during the pilot program. There is a marked increased in staff adherence which also translates to improved patient safety and outcomes.
These bars indicate how many patients in the pilot area were on one-to-one or the newly designed level of two-to-one supervision during the pilot. The goal of two-to-one was decreased staff burden of care and increased workflow. Notice a marked increase in this data across the pilot.
Proposed action items based on pilot data.
The yellow line indicates pre-pilot data collection of how often staff were adhering to recommendations and providing appropriate meal-time supervision. The orange line indicates the same data points that were collected during the pilot program. There is a marked increased in staff adherence which also translates to improved patient safety and outcomes.
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Data indicated that revising the mealtime supervision levels, signage and recommendations, coupled with increased interdisciplinary collaboration will decrease burden of care, improve patient safety outcomes and increase adherence to recommendations.
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This project resulted in a hospital-wide project to revise order sets, training and implementation of mealtime supervision for patients in a rehabilitation hospital. ​
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I was intricately involved with the hospital-wide initiative, including development, training and roll out.