title: Health care systems redesign project to improve dysphagia screening.
abstract: The purpose of this project was to improve dysphagia-screening processes in a tertiary Veterans Affairs Medical Center. The dysphagia-screening tool was redesigned on the basis of frontline clinician feedback, clinical guidelines, user satisfaction, and multidisciplinary expertise. The revised tool triggered a speech-language consult for positive screens and demonstrated higher scores in user satisfaction and task efficiency. Systems redesign processes were effective for redesigning the tool and implementing practice changes with clinicians involved in dysphagia screening.
authors.affiliation: Department of Veterans Affairs VISN 11 Center for Applied Systems Engineering (VA-CASE) (Drs Daggett and Woodward-Hagg), Department of Veterans Affairs Research & Development (R&D) Service (Dr Daggett), Department of Veterans Affairs Systems Redesign Service (Dr Woodward-Hagg), and Department of Veterans Affairs Health Services Research & Development (HSR&D) (Center for Health Information and Communication) (Drs Damush, Williams, and Bravata and Ms Plue and Mr Russell), Richard L. Roudebush VA Medical Center, Indianapolis, Indiana; Department of General Internal Medicine and Geriatrics (Dr Damush), Department of Neurology (Drs Williams and Bravata), and Department of Internal Medicine (Dr Bravata), Indiana University School of Medicine; VA HSR&D Stroke Quality Enhancement Research Initiative (QUERI), Indianapolis, Indiana (Drs Damush, Williams, and Bravata); Indiana University Center for Aging Research, Indianapolis, Indiana (Dr Damush); Regenstrief Institute, Indianapolis, Indiana (Drs Damush, Williams, and Bravata); Department of Veterans Affairs, Office of Informatics and Analytics, Analytics and Business Intelligence, Washington, DC (Mr Allen); and Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia (Dr Chumbler).
authors.forename: Virginia S
authors.initials: VS
authors.lastname: Daggett
authors.forename: Heather
authors.initials: H
authors.lastname: Woodward-Hagg
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Damush
authors.forename: Laurie
authors.initials: L
authors.lastname: Plue
authors.forename: Scott
authors.initials: S
authors.lastname: Russell
authors.forename: George
authors.initials: G
authors.lastname: Allen
authors.forename: Linda S
authors.initials: LS
authors.lastname: Williams
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Bravata
mesh_terms: D003680:Deglutition Disorders / Q000175:diagnosis*; D006751:Hospital Information Systems; D006787:Hospitals, Veterans / Q000458:organization & administration*; D006801:Humans; D007196:Indiana; D008403:Mass Screening / Q000379:methods*; D017063:Outcome Assessment, Health Care; D058996:Quality Improvement; D062606:Tertiary Care Centers; D014728:Veterans