The little things that make a big difference: how donor support is transforming care with a bedside swallow test
Special Feature
Imagine: you’ve just experienced a major medical event or critical surgery. You wake up groggy, tired, sore, and hungry.
You’re told you’re not allowed to eat or drink. A feeding tube in your nose is providing you with nutrition. And it might be a while before that tube can be removed.
Why? You’re waiting to be taken to medical imaging for a videofluoroscopic test that can check whether food and drink ends up safely in your stomach instead of your lungs when you swallow.
For many patients – including those who’ve needed intubation and others who've had strokes – wait times for that kind of video X-ray assessment can be two to four days.
But now, thanks to donor support, there’s a new machine at WRHN – the Flexible Endoscopic Evaluation of Swallowing (FEES) – that allows for bedside swallow assessments, done within minutes by highly trained Speech and Language Pathologists.
“Swallowing is something you don’t even think about – until you lose it,” says Olivia Mann, Professional Practice Lead of Speech and Language Pathology at WRHN. “But the ability to safely swallow, safely eat and drink, especially after you've gone through a major adverse event, it doesn’t just aid in recovery, it completely transforms the patient experience.”
The FEES test uses a small scope, roughly the size of an iPhone charging cable, that’s inserted through the nose. A small camera and light at the end of the scope points towards the patient’s airway and swallowing passage as they’re given small amounts of food and fluid.
The test is painless – Olivia describes the sensation as feeling a sneeze coming on – and it reveals important information, since eating or drinking with a swallowing issue can lead to choking or developing infections like pneumonia.
Not only can an SLP tell the patient whether it’s safe to eat and drink normally, they can show them too.
“You can actually see it all on a monitor in real time,” says Olivia.
If a patient needs to make adjustments to swallow more safely, they can see and adjust what they're doing live in 4K.
An SLP can administer a FEES assessment within an hour or so of receiving the request. Not only does the bedside technology eliminate wait times, it also keeps patients from having to move around the hospital unnecessarily.
For critically ill or immobile patients, that’s significant.
And for patients with swallowing issues, the FEES test can get them on the road to recovery sooner.
“We can recommend how to improve a patient’s swallow with therapy or certain dietary recommendations – and that all helps to get them home quicker,” says Olivia.
Nutrition and hydration are so important to the healing process, so we always want to make sure patients have access to nutrition in some way.
WRHN is the first hospital in the region to implement the FEES system, which will be ready for patients in September.
Since the need has been greatest at WRHN @ Midtown, the equipment will be used there first, with the goal of expanding to Queen’s Blvd., and Chicopee in the future.
Each system cost roughly $90,000. And more investment will be needed to implement FEES across WRHN’s sites.
While FEES is relatively new, Olivia says more hospitals are embracing it as they continue to understand its benefits.
“Other hospitals in the region are looking at us to see how they can implement FEES at their sites – so we’ve definitely put WRHN on the map with this,” she says.
And there’s absolutely zero way this would have been possible without donor support.
Transforming care with a bedside swallow test
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