Standardization of Modified Barium Swallow Study
Standardization of the Modified
Barium Swallow Study
The Modified Barium Swallow
Impairment Profile
the
MBSImP
Purpose & Rationale for Standardizing the MBSS
•
Evidence ─ not opinion ─ should guide clinical
decision making
•
The MBSImP is a research-based standardization
of the MBSS
•
The MBSImP provides the means for speech-
language pathologists to interpret and
communicate results of MBSS in a manner that is
Evidence-based, consistent,
specific, and accurate
Development and Overview of the MBSImP
•
Developed & validated during a 5-year NIH-funded study
•
Uses a standardized approach for assessment of
swallowing physiology
•
Reliability training
•
Assessment protocol
•
Scoring and interpretation
•
Terminology
•
Reporting
•
Observation of impairment in 17 distinct components of
physiology involved in the swallowing process are used
to systematically identify target(s) for therapeutic
intervention
Critical Necessity of Standardization in Healthcare
•
the A
gency for Healthcare Research and Quality
indicated in AHRQ Publication 01-017 that a
lack of standardization
•
Impedes understanding of true functional results
•
Produces ambiguous reporting of outcomes
•
Hinders understanding of restorative, rehabilitative
targets
The AHRQ also defines what should be standardized
•
Instrument’s contents and format
•
Data collection protocol’s approach and method
•
Analyses, minimizing variation in scoring and
interpretation
•
Reporting of results
*The MBSImP satisfies these requirements*
•
The MBSImP’s standardized online training
Clinical Benefits of MBSImP Implementation
•
Provides comprehensive education in the
physiology of normal and abnormal swallowing
•
Benefits both novice and experienced clinicians
•
Provides evidence for registered users of
competency in understanding and assessment of
swallowing function
•
The MBSImP’s standardized terminology and
assessment protocol
•
Facilitates consistency of patient care across clinicians
and healthcare facilities
•
Enhances clarity and accuracy when communicating
patient status and assessment results to physicians,
speech-language pathologists, and other members of
the healthcare team
Clinical Benefits of MBSImP Implementation
•
The MBSImP’s system for patient management
and reporting provides a method for
•
Tracking patient status over consecutive MBSS
•
Evaluating effectiveness of compensatory strategies
and therapeutic exercises used in patient treatment
plans
•
Demonstrating evidence for change in functional
status and treatment effectiveness
•
Targeting treatment with detailed treatment plans
required by third party payers and needed to optimize
patient care and outcomes
Clinical Benefits of MBSImP Implementation
•
Treatment planning specific to and appropriate
for the impaired physiology affecting swallowing
function
•
Targeted evidence-based treatment
•
Minimizes patient exposure to radiation when
using the MBSImP’s standardized protocol
Patient-Related Benefits of MBSImP Implementation
Current MBSImP Related Research
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Purpose:
This study examined the influence of clinician experience,
medical diagnostic category, swallowing impairment severity, and
use of a standardized protocol on fluoroscopy time
Findings
: the MBSImP’S standardized protocol used during MBSS
•
No unnecessary radiation exposure to patients
•
Average radiation exposure was 2.9 minutes, well within
the range of exposure times most cited
•
No significant association with patient population/Dx
Current MBSImP Related Research
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Purpose:
This study examined associations between oropharyngeal
and esophageal aspects of impairment in swallowing function
Findings
: This study demonstrated significant relationships between
impairment in oropharyngeal and esophageal clearance scores on
the MBSImP. Further, the validity of esophageal clearance scores
on MBSImP were illustrated. Study findings showed significant
associations between the MBSImP esophageal clearance score and
results of impedance manometry testing by gastroenterology
Administrative Benefits of MBSImP Implementation
•
Institutes practice and policies contemporary
with current trends in healthcare
•
Evidence-based treatment that is measurable over time
•
Accumulation of data that support the benefits
of and reimbursement for videofluoroscopically-
based assessment of oropharyngeal swallowing
dysfunction
•
Provides evidence justifying the efficacy and the
continued reimbursement for treatment
Marketing Potential from MBSImP Implementation
•
Demonstrating advanced expertise and
competency in the evaluation and treatment of
swallowing and swallowing disorders to patients,
physicians, and payers
•
Clinicians demonstrate a more in-depth understanding of
swallowing and swallowing disorders
•
Use of a research-developed, evidence-based, standardized
means of evaluation
•
Assessments that accurately identify and quantify physiologic
impairments that affect swallowing function
•
Development of individualized targeted treatment plans and
care for patient based on evidence,
not
opinion
Testimonials from Registered MBSImP Clinicians
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Useful Links
•
The NIH Funded Research Study,
Published in Dysphagia, Dec 2008
http://www.northernspeech.com/MBSImP/pdfs/MBSImP
Publication1.pdf
•
Sample copy of the MBSImP system-
generated documentation of an MBSImP
study
http://www.northernspeech.com/MBSImP/pdfs/MBSImP
SampleReport.pdf
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For Additional Information Please Visit
or Contact
Northern Speech Services
:
Purpose, development, and critical necessity of the Modified Barium Swallow Impairment Profile (MBSImP) standardization in healthcare. The MBSImP provides a research-based approach to interpreting and communicating results of the Modified Barium Swallow Study (MBSS) in a consistent and accurate manner. It is essential for improving clinical decision-making and therapeutic interventions in swallowing disorders. The standardized training offered by MBSImP benefits clinicians at all levels, enhancing their competency in assessing swallowing function.
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Presentation Transcript
The Modified Barium Swallow Impairment Profile the MBSImP Standardization of the Modified Barium Swallow Study
Purpose & Rationale for Standardizing the MBSS Evidence not opinion should guide clinical decision making The MBSImP is a research-based standardization of the MBSS The MBSImP provides the means for speech- language pathologists to interpret and communicate results of MBSS in a manner that is Evidence-based, consistent, specific, and accurate
Development and Overview of the MBSImP Developed & validated during a 5-year NIH-funded study Uses a standardized approach for assessment of swallowing physiology Reliability training Assessment protocol Scoring and interpretation Terminology Reporting Observation of impairment in 17 distinct components of physiology involved in the swallowing process are used to systematically identify target(s) for therapeutic intervention
Critical Necessity of Standardization in Healthcare the Agency for Healthcare Research and Quality indicated in AHRQ Publication 01-017 that a lack of standardization Impedes understanding of true functional results Produces ambiguous reporting of outcomes Hinders understanding of restorative, rehabilitative targets
The AHRQ also defines what should be standardized Instrument s contents and format Data collection protocol s approach and method Analyses, minimizing variation in scoring and interpretation Reporting of results *The MBSImP satisfies these requirements*
Clinical Benefits of MBSImP Implementation The MBSImP s standardized online training Provides comprehensive education in the physiology of normal and abnormal swallowing Benefits both novice and experienced clinicians Provides evidence for registered users of competency in understanding and assessment of swallowing function
Clinical Benefits of MBSImP Implementation The MBSImP s standardized terminology and assessment protocol Facilitates consistency of patient care across clinicians and healthcare facilities Enhances clarity and accuracy when communicating patient status and assessment results to physicians, speech-language pathologists, and other members of the healthcare team
Clinical Benefits of MBSImP Implementation The MBSImP s system for patient management and reporting provides a method for Tracking patient status over consecutive MBSS Evaluating effectiveness of compensatory strategies and therapeutic exercises used in patient treatment plans Demonstrating evidence for change in functional status and treatment effectiveness Targeting treatment with detailed treatment plans required by third party payers and needed to optimize patient care and outcomes
Patient-Related Benefits of MBSImP Implementation Treatment planning specific to and appropriate for the impaired physiology affecting swallowing function Targeted evidence-based treatment Minimizes patient exposure to radiation when using the MBSImP s standardized protocol
Current MBSImP Related Research Bonilha, H.S., Humphries, K., Blair, J., Hill, E., McGrattan, K., Carnes, B., Martin-Harris, B. (In Press). Radiation exposure time during MBSS: Influence of swallowing impairment severity, medical diagnosis, clinician experience, and standardized protocol use. Dysphagia. Purpose: This study examined the influence of clinician experience, medical diagnostic category, swallowing impairment severity, and use of a standardized protocol on fluoroscopy time Findings: the MBSImP S standardized protocol used during MBSS No unnecessary radiation exposure to patients Average radiation exposure was 2.9 minutes, well within the range of exposure times most cited No significant association with patient population/Dx
Current MBSImP Related Research Gullung, J.L., Hill, E.G., Castell, D.O., Martin-Harris, B. (In Press). Oropharyngeal and esophageal swallowing impairment: association and predictive value of the modified barium swallow impairment profile and combined multichannel intraluminal impedance-esophageal manometry. Annals of otology, rhinolology, and laryngology. Purpose: This study examined associations between oropharyngeal and esophageal aspects of impairment in swallowing function Findings: This study demonstrated significant relationships between impairment in oropharyngeal and esophageal clearance scores on the MBSImP. Further, the validity of esophageal clearance scores on MBSImP were illustrated. Study findings showed significant associations between the MBSImP esophageal clearance score and results of impedance manometry testing by gastroenterology
Administrative Benefits of MBSImP Implementation Institutes practice and policies contemporary with current trends in healthcare Evidence-based treatment that is measurable over time Accumulation of data that support the benefits of and reimbursement for videofluoroscopically- based assessment of oropharyngeal swallowing dysfunction Provides evidence justifying the efficacy and the continued reimbursement for treatment
Marketing Potential from MBSImP Implementation Demonstrating advanced expertise and competency in the evaluation and treatment of swallowing and swallowing disorders to patients, physicians, and payers Clinicians demonstrate a more in-depth understanding of swallowing and swallowing disorders Use of a research-developed, evidence-based, standardized means of evaluation Assessments that accurately identify and quantify physiologic impairments that affect swallowing function Development of individualized targeted treatment plans and care for patient based on evidence, not opinion
Testimonials from Registered MBSImP Clinicians I am so excited to have this standardization protocol in place. I have been frustrated for a long time with the differences in interpretation of MBSs from one clinician to another. I think this will add credibility to our profession. I am excited to start using the reports and contribute to research! "The characteristics for each component are well defined, the videos provide excellent examples of the components, the attention to detail is outstanding. Learning is enhanced by the availability of the replay of the videos for study. I really enjoyed the course and am recommending it to all my colleagues. It was positively challenging. I feel so much more confident when evaluating our VFSS results now and it truly does save time in the long run. I did the online course and I found it to be exceptional. It s objective and allows for better communication between trained therapists. I can t recommend it enough.
Useful Links The NIH Funded Research Study, Published in Dysphagia, Dec 2008 http://www.northernspeech.com/MBSImP/pdfs/MBSImP Publication1.pdf Sample copy of the MBSImP system- generated documentation of an MBSImP study http://www.northernspeech.com/MBSImP/pdfs/MBSImP SampleReport.pdf
For Additional Information Please Visit or Contact Northern Speech Services: NorthernSpeech.com/mbsimp or mbsimp@northernspeech.com
