Title : Achieving 100% dysphagia screening compliance in acute stroke patients outperforming national & state
Abstract:
Background & Significance: Dysphagia screening prior to oral intake is a core AHA/ASA Get With The Guidelines®–Stroke (GWTG Stroke) quality measure and a DNV Stroke Center requirement. National GWTG data report average compliance of 83.9%, with Florida hospitals averaging 85.5%, illustrating ongoing variability and patient safety risk. Missed screening increases aspiration, pneumonia, length of stay, and mortality. This initiative aimed to improve consistency and sustainability of dysphagia screening in the Emergency Department (ED).
Key Innovations: Interventions included:
1. Embedding dysphagia screening orders into all stroke related imaging studies.
2. Targeted re education of ED providers on non typical stroke symptoms (e.g., dizziness, nausea) and the requirement for screening prior to oral medications.
3. Real time abstraction of all ED stroke cases by the stroke program manager to identify documentation gaps and provide immediate feedback.
Results: Baseline compliance was 90%, exceeding national and state benchmarks. Following implementation, compliance increased to 95.1% and subsequently achieved 100%, significantly outperforming GWTG national and Florida averages. Improvements were sustained across reporting periods with reliable screening prior to oral intake for all stroke patients.
Conclusion/Implications: Standardized workflow integration, provider education, and real time data oversight can eliminate variability and achieve top decile performance. This model supports AHA/GWTG Stroke measure compliance and DNV certification readiness.
