TY - JOUR
T1 - Implementation of the VA Intensive Dysphagia Treatment Program
T2 - A Mixed-Methods Evaluation
AU - Yee, Joanne
AU - Pulia, Michael
AU - Knobloch, Mary Jo
AU - Martinez, Rachael
AU - Daggett, Sarah
AU - Smith, Bridget
AU - Musson, Nan
AU - Rogus-Pulia, Nicole
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding was provided by the Geriatrics and Extended Care and Office of Rural Health services of the VA and to N.R.P. from the NIH (grant number 1K76AG068590). The manuscript was prepared at William S. Middleton Veteran Affairs Hospital at the Geriatric Research, Educational and Clinical Center in Madison, Wisconsin (GRECC manuscript 009-2002). The views and content expressed in this article are solely the responsibility of the authors and do not necessarily reflect the position, policy, or official views of the Department of Veteran Affairs or the U.S. government.
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding was provided by the Geriatrics and Extended Care and Office of Rural Health services of the VA and to N.R.P. from the NIH (grant number 1K76AG068590). The manuscript was prepared at William S. Middleton Veteran Affairs Hospital at the Geriatric Research, Educational and Clinical Center in Madison, Wisconsin (GRECC manuscript 009-2002). The views and content expressed in this article are solely the responsibility of the authors and do not necessarily reflect the position, policy, or official views of the Department of Veteran Affairs or the U.S. government.
Publisher Copyright:
© The Author(s) 2022.
PY - 2022
Y1 - 2022
N2 - The Department of Veterans Affairs (VA) Intensive Dysphagia Treatment program serves a critical role in facilitating improvements to quality of care, standardization of outcomes, and increased access to structured therapy for Veterans with dysphagia. It has been implemented at 26 sites nationally and continues expanding. An explanatory sequential mixed-methods design was utilized for program evaluation to identify barriers and facilitators to implementation as reported by speech-language pathologists (SLPs) participating in the program. All 23 IDT program SLPs were invited to participate in an online survey. SLPs were asked to describe etiologies referred for SLP evaluation, most and least clinically useful program aspects, and characteristics of patients recommended for therapy. Qualitative interviews/focus groups were then conducted with 9 SLPs at 3 facilities with varying levels of program experience. Transcripts underwent systems engineering framework informed deductive thematic analysis. Interview/focus groups revealed overall positive feedback. Barriers included data entry challenges and provider understanding of long-term program goals, while facilitators included program structure enabling increased patient follow-up, outcomes tracking, and training in new treatment modalities. Through this evaluation process, program leadership garnered actionable feedback to improve further implementation of the IDT program. Ongoing efforts will further improve data entry, site onboarding procedures, and program communication.
AB - The Department of Veterans Affairs (VA) Intensive Dysphagia Treatment program serves a critical role in facilitating improvements to quality of care, standardization of outcomes, and increased access to structured therapy for Veterans with dysphagia. It has been implemented at 26 sites nationally and continues expanding. An explanatory sequential mixed-methods design was utilized for program evaluation to identify barriers and facilitators to implementation as reported by speech-language pathologists (SLPs) participating in the program. All 23 IDT program SLPs were invited to participate in an online survey. SLPs were asked to describe etiologies referred for SLP evaluation, most and least clinically useful program aspects, and characteristics of patients recommended for therapy. Qualitative interviews/focus groups were then conducted with 9 SLPs at 3 facilities with varying levels of program experience. Transcripts underwent systems engineering framework informed deductive thematic analysis. Interview/focus groups revealed overall positive feedback. Barriers included data entry challenges and provider understanding of long-term program goals, while facilitators included program structure enabling increased patient follow-up, outcomes tracking, and training in new treatment modalities. Through this evaluation process, program leadership garnered actionable feedback to improve further implementation of the IDT program. Ongoing efforts will further improve data entry, site onboarding procedures, and program communication.
KW - Swallowing
KW - implementation science
KW - mixed methods
KW - program evaluation
KW - speech-language pathologists
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U2 - 10.1177/11786329221121207
DO - 10.1177/11786329221121207
M3 - Article
C2 - 36081831
AN - SCOPUS:85137595594
SN - 1178-6329
VL - 15
JO - Health Services Insights
JF - Health Services Insights
ER -
