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Updated: Feb 4, 2026

Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models
Published on: March 1, 2015
A pilot study assessing clinic value in pediatric pharyngeal dysphagia: The OPPS/cost method
Steven Coppess1, Jennifer Soares2, Bianca K Frogner3,4
1University of Washington School of Medicine, University of Washington, Seattle, Washington, U.S.A.
Objectives/Hypothesis:
Given the costs of healthcare, capitation, and desires for quality improvement (QI), there is a need to better assess healthcare value. Time-driven activity-based costing and the Quadruple Aim have evaluated value by assessing health outcomes and provider experiences relative to costs. The proposed OPPS/Cost method expands on this to examine value for aerodigestive clinic treatment of pediatric persistent pharyngeal dysphagia: O + P1 + P2 + S/Cost (O = objective health [video-fluoroscopic swallow study results], P1 = patient/family experience [Consumer Assessment of Healthcare Providers and Systems], P2 = provider experience [Copenhagen Burnout Inventory {CBI}], S = subjective health [Feeding/Swallowing-Impact Survey], C = cost [time-driven activity-based costing]).
Study Design:
Use of QI time data, surveys, and retrospective chart review for 56 patient encounters.
Methods:
Staff interviews were used to develop process maps, and monetary values were assigned to activities. OPPS/Cost outcomes were normalized amongst variables, and composite values were calculated. Comparisons were made using a Student t test for pre- and postclinic relocation over a 14-month period.
Results:
Time reductions were check-in (13 minutes/patient), rooming (21 minutes/patient), and providers (4 minutes/patient). Patient in-room wait time increased (4 minutes/patient). The CBI identified burnout as an area for improvement. OPPS/Cost composite values increased by 14%, with a 1.7% cost reduction, improvement in objective and subjective health outcomes of 47.4% (P < .05) and 7.3%, respectively, and stable patient/family experience.
Conclusions:
OPPS/Cost is feasible in an interdisciplinary clinic and helped evaluate value during a clinic relocation. The QI opportunities identified are indicative of the potential of OPPS/Cost.
Level Of Evidence:
NA Laryngoscope, 129:1527-1532, 2019.
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