Article

Despite the wide implementation of dysphagia therapies, it is unclear whether
these therapies are successfully communicated beyond the inpatient setting. The
aim of this study was to examine the rate of dysphagia recommendation omissions
in hospital discharge summaries for high-risk subacute care (i.e., skilled
nursing facility, rehabilitation, long-term care) populations. We performed a
retrospective cohort study that included all stroke and hip fracture patients
billed for inpatient dysphagia evaluations by speech-language pathologists (SLPs)
and discharged to subacute care from 2003 through 2005 from a single large
academic medical center (N = 187). 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).
Forty-five percent of discharge summaries omitted all SLP dysphagia
recommendations. Forty-seven percent (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. Discharge summaries omitted all categories of SLP
recommendations at notably high rates. Improved post-hospital communication
strategies are needed for discharges to subacute care.

Langue : ANGLAIS