Stroke and Stroke Rehabilitation: Screening for Dysphagia
Percentage of patients aged 18 years and older with a diagnosis of ischemic stroke or intracranial hemorrhage who receive any food, fluids or medication by mouth (PO) for whom a dysphagia screening was performed prior to PO intake in accordance with a dysphagia screening tool approved by the institution in which the patient is receiving care
ACP does not support measure NQF 0243: “Stroke and Stroke Rehabilitation: Screening for Dysphagia” because it lacks appropriate provision for risk stratification. In addition, the screening tools for dysphagia are not standardized. Application of the measure to all stroke patients appears to encourage overuse and may lead to inappropriate delays in feeding in some cases. The measure would be improved by clearer guidance on when to screen, how to assess risk based on disease severity, and what represents best clinical practice in how to screen.