Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

Newman, Roger D.; Nightingale, Julie

doi:10.1016/j.radi.2011.04.005

Cited by 11 publications

(10 citation statements)

References 7 publications

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“…We found that the majority of clinics are practitioner-led, usually run by two SLTs and a radiographer. This is positive as practitioner-led clinics have been shown to increase access to clinics without compromising safety [9] and reduce clinic costs [10] when compared to Radiologist led clinics.…”

Section: Discussionmentioning

confidence: 99%

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey

et al. 2020

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Videofluoroscopy (VFS) is considered one of the gold-standard assessments of swallowing. Whilst guidelines for the application and conduct of VFS exist, their translation into clinical practice remain challenging. To build a greater understanding on how VFS clinics operate in the UK. A web-based survey was shared with speech and language therapists (SLTs) working in VFS clinics via professional networks and social media from October 2018 to January 2019. 101 responses were received. Two thirds of clinics were SLT-led, with the majority of clinics being run by two SLTs (73.6%) and a radiographer (95.5%) also known as radiologic technologists, diagnostic radiographers and medical radiation technologists. Less than 50% of radiographers had received specialist training. Around half of the clinics used a standard assessment or analysis protocol and 88.1% a rating scale. Set recipes for a range of textures were used in 53.4% of VFS clinics. Barium and water soluble contrasts were used, but only 15.8% knew the concentration of contrast used. The most commonly reported VFS pulse and frame rate was 15 per second. There was evidence of a lack of SLT knowledge regarding technical operation of VFS. Screening times varied from 0.7–10 min (median 3 min, IQR 2.5–3.5). Around 50% of respondents reported quality issues affecting analysis. In a survey of UK SLTs, translation of VFS guidance into practice was found to be limited which may impact on the quality of assessment and analysis. Collaboration with radiology, strengthening of guidelines and greater uptake of specialist training is deemed essential.

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Section: Discussionmentioning

confidence: 99%

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey

et al. 2020

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“…Although there are several software programmes available to assist recording analysis and offer a more objective interpretation of VFSS and FEES (29), they are limited in terms of clinical use due to the considerable time required to use the software (20). VFSS and FEES clinics typically see multiple patients consecutively due to limited availability of the equipment and various clinical staff required (30), making routine use of software difficult.…”

Section: Eligibility Criteriamentioning

confidence: 99%

Psychometric Properties of Visuoperceptual Measures of Videofluoroscopic and Fibre-Endoscopic Evaluations of Swallowing: A Systematic Review

et al. 2018

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Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and Videofluoroscopic Swallow Studies (VFSS) are instrumental assessments of dysphagia which provide videos of the internal structures of swallowing. They are commonly regarded as 'gold-standard' assessments; however, there is no consensus regarding a gold-standard measure to analyse the video recordings that they produce. Measures require sound psychometric properties to be suitable for clinical or research purposes. To date, no review of psychometric properties of FEES and VFSS measures has been undertaken or formally reported. This review assessed the quality of the psychometric properties of visuoperceptual measures of FEES and VFSS. Electronic databases were searched for studies reporting on psychometric qualities of visuoperceptual measures which are used to analyse recordings from FEES and VFSS. All dates until February 2017 were included. The Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist was used to evaluate the methodical quality of studies. The measures' overall quality was then assessed by combining COSMIN ratings with quality criteria. Forty-five studies, reporting on 39 measures, met the inclusion criteria for this review. Data about the measures' psychometric properties were very limited. Twenty-one measures had information available about reliability only, while 18 had information on up to five of the possible nine psychometric properties categorised within the COSMIN framework. The majority of the FEES and VFSS measures' psychometric properties were rated as 'indeterminate' overall, due to the small number of studies, issues with design, statistical analyses, and reporting practices of extant studies. There is insufficient evidence to recommend any individual measure included in this review as valid and reliable to interpret VFSS and FEES recordings. Further research, which utilises robust methodological design and reporting, is needed to examine the psychometric properties of measures for FEES and VFSS.

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“…Three (5 %) of the 57 included studies evaluated ESP and all were performed in the UK. Two of these studies used the uncontrolled pre-and post-intervention design and covered different patient groups: accident & emergency (A&E) [92], inpatients and outpatients [93]. The third study used a time series design on A&E patients [94].…”

Section: Extended Scope Practicementioning

confidence: 99%

“…The third study used a time series design on A&E patients [94]. Different components of the patients' waiting times were reported: RTAT [92,94] and PEWT [93]. All three studies reported improved patients waiting times.…”

Section: Extended Scope Practicementioning

confidence: 99%

“…All three studies reported improved patients waiting times. For example, regression analysis suggests that increased proportion of A&E examinations reported by ESP radiographers is associated with 36.8 % reduction in RTAT, p<0.001 [94], and there was a 75 and 62 % drop in the mean PEWT for inpatient and outpatient video fluoroscopy, respectively following ESP implementation [93].…”

Section: Extended Scope Practicementioning

confidence: 99%

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The Effectiveness of Service Delivery Initiatives at Improving Patients’ Waiting Times in Clinical Radiology Departments: A Systematic Review

et al. 2014

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We reviewed the literature for the impact of service delivery initiatives (SDIs) on patients' waiting times within radiology departments. We searched MEDLINE, EMBASE, CINAHL, INSPEC and The Cochrane Library for relevant articles published between 1995 and February, 2013. The Cochrane EPOC risk of bias tool was used to assess the risk of bias on studies that met specified design criteria. Fifty-seven studies met the inclusion criteria. The types of SDI implemented included extended scope practice (ESP, three studies), quality management (12 studies), productivity-enhancing technologies (PETs, 29 studies), multiple interventions (11 studies), outsourcing and pay-for-performance (one study each). The uncontrolled pre-and post-intervention and the postintervention designs were used in 54 (95 %) of the studies. The reporting quality was poor: many of the studies did not test and/or report the statistical significance of their results. The studies were highly heterogeneous, therefore metaanalysis was inappropriate. The following type of SDIs showed promising results: extended scope practice; quality management methodologies including Six Sigma, Lean methodology, and continuous quality improvement; productivityenhancing technologies including speech recognition reporting, teleradiology and computerised physician order entry systems. We have suggested improved study design and the mapping of the definitions of patient waiting times in radiology to generic timelines as a starting point for moving towards a situation where it becomes less restrictive to compare and/or pool the results of future studies in a meta-analysis.

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Improving patient access to videofluoroscopy services: Role of the practitioner-led clinic

Cited by 11 publications

References 7 publications

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey

The Landscape of Videofluoroscopy in the UK: A Web-Based Survey

Psychometric Properties of Visuoperceptual Measures of Videofluoroscopic and Fibre-Endoscopic Evaluations of Swallowing: A Systematic Review

The Effectiveness of Service Delivery Initiatives at Improving Patients’ Waiting Times in Clinical Radiology Departments: A Systematic Review

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