Dysphagia evaluation and care in the hospital setting: the need for protocolization

Dysphagia accounts for a small portion of hospital admissions but is associated with severe complications. This has been shown to result in longer hospital length of stay and increased risk of mortality with certain other diagnoses. Although there has been much research on causes and interventions for dysphagia, there has been variable impact in actual hospital practice. Also, nonuniform approaches to evaluating patients, such as screening high-risk populations, makes it difficult to measure outcomes of care. This commentary advises a more systematic approach that includes standardized protocols, risk stratification, and screening high-risk patients; makes the case for broadening the classification of dysphagia; and suggests a growing role for adjunctive enteral nutrition in patients with some compromise to swallowing.