Seeing the bigger picture: Feasibility of TeleVFSS to support Geraldton Regional Hospital (GRH)
Tracks
7
Acute care – adult
Assessment
Dysphagia
Education
Inclusive education
Interprofessional collaborative practice
Project planning/management
Research
Service delivery
Supervision
Swallowing
Telepractice
Videofluoroscopic swallow study (VFSS)
Workforce
| Saturday, June 14, 2025 |
| 12:20 PM - 12:30 PM |
| Knowledge Hub | Halls MNO, Ground Level |
Overview
Louise Cleary
Details
⏫ Rapid impact
⏲️ 12.20pm - 12.30pm
⌛ 10-minutes
📚 Assumed knowledge of attendees: Intermediate (Some previous learning/working knowledge of topic e.g. treated a few cases)
⏲️ 12.20pm - 12.30pm
⌛ 10-minutes
📚 Assumed knowledge of attendees: Intermediate (Some previous learning/working knowledge of topic e.g. treated a few cases)
Presenter
Miss Louise Cleary
Osborne Park Hospital
Seeing the bigger picture: Feasibility of TeleVFSS to support Geraldton Regional Hospital (GRH)
12:20 PM - 12:30 PMPresentation summary
Background: Geraldton Regional Hospital (GRH) have Videofluoroscopic swallow study (VFSS) equipment, but no VFSS trained speech pathologists. Telepractice VFSS (TeleVFSS) may be a feasible solution to increase capacity to deliver safe, equitable, high-quality VFSS services and workforce competency for GRH. This project was completed as the first phase in developing a TeleVFSS training program between Osborne Park Hospital (OPH) and GRH.
Research Question: What is the feasibility of conducting VFSS with a concurrent livestream to an external computer?
Method: A pilot feasibility study (N=10) was completed at OPH to explore if VFSS assessed by a speech pathologist via concurrent livestream to an OPH computer can: i) achieve a score of 4/5 (livestream available with mostly adequate quality, brief occasions of poor-quality, scores not impacted) or better on a TeleVFSS image rating scale; and ii) be attributed a Penetration Aspiration Scale (PAS) score. The NMHS Virtual Care Team led equipment trials and set up.
Results: Three telehealth platforms were trialled, MS teams, Avaya, and Health Direct. 60% (6/10) of VFSS assessments scored 4/5 or higher on the TeleVFSS image rating scale: 66% (2/3) on MS teams; 0% (0/1) on Avaya; 100% (5/5) on Health Direct. 70% (7/10) of VFSS assessments scored on concurrent live stream were attributed a PAS score: 75% (3/4) on MS teams; 0% (0/1) on Avaya; 100% (5/5) on Health Direct.
Conclusion: TeleVFSS via Health Direct to an on-site computer was perceived to provide adequate image quality and was consistently attributed a PAS score. As a result, progress towards phase 2 of the project has progressed, commencing in November 2024 determining feasibility of TeleVFSS between GHS and OPH. Focus will be on investigating bandwidth and equipment and exploring the feasibility of livestreaming VFSS from GRH to an OPH computer.
Research Question: What is the feasibility of conducting VFSS with a concurrent livestream to an external computer?
Method: A pilot feasibility study (N=10) was completed at OPH to explore if VFSS assessed by a speech pathologist via concurrent livestream to an OPH computer can: i) achieve a score of 4/5 (livestream available with mostly adequate quality, brief occasions of poor-quality, scores not impacted) or better on a TeleVFSS image rating scale; and ii) be attributed a Penetration Aspiration Scale (PAS) score. The NMHS Virtual Care Team led equipment trials and set up.
Results: Three telehealth platforms were trialled, MS teams, Avaya, and Health Direct. 60% (6/10) of VFSS assessments scored 4/5 or higher on the TeleVFSS image rating scale: 66% (2/3) on MS teams; 0% (0/1) on Avaya; 100% (5/5) on Health Direct. 70% (7/10) of VFSS assessments scored on concurrent live stream were attributed a PAS score: 75% (3/4) on MS teams; 0% (0/1) on Avaya; 100% (5/5) on Health Direct.
Conclusion: TeleVFSS via Health Direct to an on-site computer was perceived to provide adequate image quality and was consistently attributed a PAS score. As a result, progress towards phase 2 of the project has progressed, commencing in November 2024 determining feasibility of TeleVFSS between GHS and OPH. Focus will be on investigating bandwidth and equipment and exploring the feasibility of livestreaming VFSS from GRH to an OPH computer.
Refrences
1. Altman KW. Dysphagia evaluation and care in the hospital setting: the need for protocolization. Otolaryngology-Head & Neck Surgery. 2011.
2. Cichero, JA, et al. Triaging dysphagia: nurse screening for dysphagia in an acute hospital. Journal of Clinical Nursing. 2009.
3. Cichero JA, et al. Definition, prevalence and burden of oropharyngeal dysphagia: a serious problem among older adults worldwide and the impact on prognosis and hospital resources. Nestle Nutr Inst Workshop Ser. 2012.
4. Ferraris VA, Oropharyngeal dysphagia after cardiac operations. Annals of Thoracic Surgery. 2001.
5. Guyomard V, et al. Effect of dysphasia and dysphagia on inpatient mortality and hospital length of stay: A database study. Journal of American Geriatrics Society. 2009.
6. Sura, L., et al. (2012). Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 7: 287-298
7. Lin LC, et al. Prevalence of impaired swallowing in institutionalized older people in Taiwan. Journal of the American Geriatrics Society. 2002.
8. Martino R, et al. Dysphagia after stroke: Incidence, diagnosis and pulmonary complications. Stroke. 2005.
9. Morris H. Dysphagia in the elderly. A management challenge for nurses. British Journal of Nursing. 2006.
10. Roy N, et al. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Annals of Otology, Rhinology & Laryngology. 2007.
11. Odderson IR, et al. Swallow management in patients on an acute stroke pathway: quality is cost effective. Arch Phys Med Rehabil. 1995. https://doi.org/10.1016/S0003-9993(95)80121-9
12. Logemann, J. A. Manual for the videofluorographic study of swallowing. Little, Brown. 1986
13. Garon BR, et al. Silent aspiration: results of 2,000 video fluoroscopic evaluations. J Neurosci Nurs. 2009
14. Leder SB, et al. Silent aspiration risk is volume-dependent. Dyphagia. 2011.
15. Ramono M, et al. The diagnostic test accuracy of clinical swallow assessment for oropharyngeal aspiration: A systematic review. JBI Libr Syst Rev. 2012. https://doi/org10.11124/01938924-201210561-00002
16. Burns CL, et al. A dynamic image quality evaluation of videofluoroscopy images: Considerations for telepractice applications. 2015. https://doi.org/10.1007/s00455-015-9626-1
17. Burns CL, et al. Conducting Real-Time Videofluoroscopic Swallow Study via Telepractice: A Preliminary Feasibility and Reliability Study. Dysphagia, 2016. https://doi.org/10.1007/s00455-016-9701-2
2. Cichero, JA, et al. Triaging dysphagia: nurse screening for dysphagia in an acute hospital. Journal of Clinical Nursing. 2009.
3. Cichero JA, et al. Definition, prevalence and burden of oropharyngeal dysphagia: a serious problem among older adults worldwide and the impact on prognosis and hospital resources. Nestle Nutr Inst Workshop Ser. 2012.
4. Ferraris VA, Oropharyngeal dysphagia after cardiac operations. Annals of Thoracic Surgery. 2001.
5. Guyomard V, et al. Effect of dysphasia and dysphagia on inpatient mortality and hospital length of stay: A database study. Journal of American Geriatrics Society. 2009.
6. Sura, L., et al. (2012). Dysphagia in the elderly: management and nutritional considerations. Clin Interv Aging 7: 287-298
7. Lin LC, et al. Prevalence of impaired swallowing in institutionalized older people in Taiwan. Journal of the American Geriatrics Society. 2002.
8. Martino R, et al. Dysphagia after stroke: Incidence, diagnosis and pulmonary complications. Stroke. 2005.
9. Morris H. Dysphagia in the elderly. A management challenge for nurses. British Journal of Nursing. 2006.
10. Roy N, et al. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Annals of Otology, Rhinology & Laryngology. 2007.
11. Odderson IR, et al. Swallow management in patients on an acute stroke pathway: quality is cost effective. Arch Phys Med Rehabil. 1995. https://doi.org/10.1016/S0003-9993(95)80121-9
12. Logemann, J. A. Manual for the videofluorographic study of swallowing. Little, Brown. 1986
13. Garon BR, et al. Silent aspiration: results of 2,000 video fluoroscopic evaluations. J Neurosci Nurs. 2009
14. Leder SB, et al. Silent aspiration risk is volume-dependent. Dyphagia. 2011.
15. Ramono M, et al. The diagnostic test accuracy of clinical swallow assessment for oropharyngeal aspiration: A systematic review. JBI Libr Syst Rev. 2012. https://doi/org10.11124/01938924-201210561-00002
16. Burns CL, et al. A dynamic image quality evaluation of videofluoroscopy images: Considerations for telepractice applications. 2015. https://doi.org/10.1007/s00455-015-9626-1
17. Burns CL, et al. Conducting Real-Time Videofluoroscopic Swallow Study via Telepractice: A Preliminary Feasibility and Reliability Study. Dysphagia, 2016. https://doi.org/10.1007/s00455-016-9701-2
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Louise Cleary is a Senior Speech Pathologist with 13 years’ experience in tertiary acute and rehabilitations hospitals. Her passion is stroke rehabilitation and implementation of innovative approaches to improve service delivery. Louise is an early career researcher and an advanced scope clinician who supports local and rural staff in complex swallow management.
Louise Cleary is the lead investigator on this project who conceptualised the project idea, led the overall project development and team coordination of the project, completed data collection and contributed to data analysis.
The information contained in this program is current at of the time of publishing but is subject to changes made without notice.
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