Implementation of the VA Intensive Dysphagia Treatment Program: A Mixed-Methods Evaluation.

Area of Science:

• Healthcare Management
• Speech-Language Pathology
• Program Evaluation

Background:

• The Department of Veterans Affairs (VA) Intensive Dysphagia Treatment (IDT) program aims to enhance care quality, standardize outcomes, and increase access to structured therapy for Veterans.
• The program is currently implemented at 26 sites nationally and is undergoing expansion.

Purpose of the Study:

• To evaluate the VA's Intensive Dysphagia Treatment (IDT) program.
• To identify barriers and facilitators to program implementation from the perspective of participating speech-language pathologists (SLPs).

Main Methods:

• An explanatory sequential mixed-methods design was employed.
• An online survey was administered to 23 IDT program SLPs, followed by qualitative interviews/focus groups with 9 SLPs across 3 facilities.
• Transcripts were analyzed using a systems engineering framework-informed deductive thematic analysis.

Main Results:

• Overall positive feedback was received from participating SLPs.
• Identified barriers included data entry challenges and unclear long-term program goals.
• Facilitators included the program's structure, which supported improved patient follow-up, outcomes tracking, and training in new treatment modalities.

Conclusions:

• The program evaluation provided actionable feedback for improving the IDT program's implementation.
• Ongoing efforts focus on enhancing data entry, site onboarding, and program communication to further optimize the program.