Impact of an Electronic Medical Record-Based Clinical Decision Support Tool for Dysphagia Screening on Care Quality

Kamakshi Lakshminarayan, Nassir Rostambeigi, Candace C. Fuller, James M. Peacock, Albert W. Tsai

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background and Purpose: Dysphagia screening (DS) before oral intake in patients with acute stroke is a hospital-level performance measure. We report outcomes of an initiative to improve compliance to this quality measure. Methods: The design was a pre-versus postintervention comparison study. The Intervention was an electronic medical record-based clinical DS system embedded within stroke admission orders. The clinical DS was designed to facilitate DS in patients with stroke. The primary outcome was compliance to a process measure in patients with ischemic stroke: performance of a swallow screen before oral intake. Results: DS measure compliance increased from 36% to 74% (P=0.001). Chart audits found screened patients were more likely to have clinical DS-embedded admission orders initiated or stroke unit admission. Conclusion - The electronic medical record offers a ready platform for clinical DS implementation. DS is a difficult performance measure to improve. The described clinical DS has the potential for improving performance on this challenging care quality measure.

Original languageEnglish (US)
Pages (from-to)3399-3401
Number of pages3
JournalStroke
Volume43
Issue number12
DOIs
StatePublished - Dec 2012

Keywords

  • Clinical decision support
  • Dysphagia screening
  • EMR
  • Organized stroke care
  • Outcomes
  • Stroke care
  • Stroke units

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