Announcement from the Canadian IDDSI Expert Reference Group

Canadian IDDSI Expert Reference Group formed in preparation for January 1, 2019 launch of IDDSI in Canada

Canada is in the preparation stage of implementing the International Dysphagia Diet Standardisation Initiative (IDDSI) framework in healthcare facilities and community settings across the country. Although we know that implementation of IDDSI is critical for optimizing safety and nutrition care for those living with dysphagia, we recognize that the implementation process is complex. Following the direction of many other countries, Canadian practitioners felt it was important to convene an expert reference group to guide and support IDDSI implementation here in Canada.

We are pleased to announce the formation of the Canadian IDDSI Expert Reference Group (CIERG), a group of dedicated volunteer professionals from across Canada. Together with Canadian representatives from the International IDDSI board, this group will promote, monitor, support, advocate and communicate recommendations for implementation of the IDDSI framework within Canadian organizations and industry.

Read full announcement

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IDDSI International Stakeholder Survey: Soft [but not necessarily bite-sized]

The International Dysphagia Diet Standardisation Initiative has received a number of questions suggesting that people are looking for a label and testing methods for foods that are ‘soft’ but not necessarily served in ‘bite-sized’ pieces (e.g. without particle size restriction).  Specifically, “how do we order ‘soft’ whole foods (e.g. omelette, fish), while avoiding things like nuts, tough meats, stringy/fibrous foods, etc?” 

In order to address this question a short international stakeholder survey has been created and your input would be appreciated. The survey should take no more than 4 minutes to complete and can be found here: https://www.surveymonkey.com/r/KYW2VFN

The survey will be open until 31 July 2018.

Please feel free to circulate the survey link widely.  Results will be shared in upcoming e-bites and on the IDDSI website.

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CAOT-BC Dysphagia Practice Network Meeting: November 15, 2017

Topic: Results of the CADTH Environmental Scan Report: Feeding and Swallowing Assessment Services for Pediatric Populations in Canada

Presenter: Karen Derry, Speech-Language Pathologist and Collaborative Practice Lead for Sunny Hill Health Centre’s Acute Rehabilitation Team  

Description: How do we support best practices in pediatric feeding and swallowing assessment in Canada? What are these best practices, how are they carried out, and who is involved? In what ways can we support the needs of these children in hospital and community clinics, or through telerehabilitation?

Sunny Hill Health Centre for Children’s Child Development & Rehabilitation Evidence Centre recently partnered with speech-language pathologists and occupational therapists throughout Canada and the Canadian Agency for Drugs and Technologies in Health (CADTH) to answer these questions by collaborating on an environmental scan feeding assessment practices in pediatric health centres. CADTH conducted the environmental scan, which included a pan-Canadian survey, stakeholder consultation, and the publication of a CADTH Environmental Scan Report: Feeding and Swallowing Assessment Services for Pediatric Populations in Canada: Service Provision, Practice Models, and Assessment Tools (March 2017). 

This meeting will take place by webinar. Registration is required to participate.

Date: November 15, 2017

Time: 12:00pm - 1:00pm Pacific Time

Location: Webinar

Registration: https://www.caot.ca/viewEvent.html?productId=9817

Cost:

Free for CAOT-BC members

$20 for non-members

If you have any questions please contact CAOT-BC.

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Evidence for your Practice: Feeding and swallowing assessment practices in Canada

Post by Stephanie Glegg, MSc, BSc(OT)

How do we support best practices in pediatric feeding and swallowing assessment in Canada? What are these best practices, how are they carried out, and who is involved? In what ways can we support the needs of these children in hospital and community clinics, or through telerehabilitation?

Sunny Hill Health Centre for Children’s Child Development & Rehabilitation Evidence Centre recently partnered with the Canadian Agency for Drugs and Technologies in Health (CADTH) to answer these questions by collaborating on an environmental scan of feeding assessment practices in pediatric health centres across Canada. CADTH conducted the environmental scan, which included a pan-Canadian survey, stakeholder consultation, and the publication of a CADTH Environmental Scan Report: Feeding and Swallowing Assessment Services for Pediatric Populations in Canada: Service Provision, Practice Models, and Assessment Tools (March 2017).

The goal of the environmental scan was to identify and to summarize Canadian pediatric feeding and swallowing assessment services. Key topics covered by the scan included:

• Practice models in place at the health centres surveyed
• Populations served
• Organization of services (e.g. feeding team-based vs. clinical program-based)
• Health professional involvement and scope of practice
• Assessment procedures in use and under consideration
• Practice guidelines, policies and procedures in use
• Outcome measures in use
• Required service provision for inpatient, outpatient, rehabilitation and teleconsultation populations
• The full findings can be accessed on the CADTH website.

The scan was preceded by the generation of three CADTH Rapid Response Reports that synthesized related evidence. Key messages are summarized below: 

1. Assessment of pediatric feeding and swallowing

• No evidence-based guidelines were identified in the reviewed literature for assessing feeding and swallowing in children
• One systematic review suggested limited evidence about the validity and reliability of non-instrumental measures of pediatric dysphagia (i.e. those that do not require specialized equipment)

2. Fiberoptic endoscopic evaluation of swallowing (FEES) for pediatric patients with dysphagia: Clinical effectiveness

• Two non-randomized studies were found that had conflicting evidence on the clinical effectiveness of FEES. One concluded that FEES was a useful management tool in children with dysphagia, while the other did not find a significant improvement of long-term feeding status in children with dysphagia evaluated by FEES. A third non-randomized study supported the use of the FEES to address the high error rate observed during clinical assessment.

3. Three-ounce water swallow challenge for oropharyngeal dysphagia: Diagnostic accuracy and guidelines.

• No relevant pediatric literature was identified.
• One non-randomized study of 25 male adults compared the water swallow challenge to videofluoroscopic swallow studies (VFSS). The authors concluded that the water swallow challenge was useful and valid for determining aspiration risk, with 100% sensitivity, 64% specificity, a 78% positive predictive value, and a 100% negative predictive value.
• A second non-randomized study of adults concluded that a combined approach to screening for aspiration risk that included the water swallow challenge and the Clinical Predictive Scale of Aspiration (CPSA) was useful and more efficient than relying on VFSS alone. The diagnostic accuracy of the water swallow challenge was determined to have 87.3% sensitivity and 42.3% specificity. 

A new toolkit, the Optimizing feeding and swallowing in children with physical and developmental disabilities handbook has also been developed by Holland-Bloorview’s Evidence to Care Team, which incorporates the findings of the environmental scan along with other key evidence. This toolkit was developed specifically for clinicians, and provides a framework to help guide decision making about the clinical assessment and management of feeding and swallowing issues in children with physical and developmental disabilities. 

Together, these resources form a foundation for understanding more clearly how feeding and swallowing assessment is and can be carried out across the country. This information can inform the development and refinement of feeding and swallowing assessment services in a range of clinical contexts, and will be of high interest to occupational therapists and other clinicians involved in this area of practice.

CAOT-BC Dysphagia Practice Network Meeting: September 13, 2017

Topic: Learn more about the Feeding, Eating & Swallowing orientation program for occupational therapists at Vancouver Coastal Health. Teresa Green will review the development and implementation of this program and describe the current orientation program including competencies, classroom sessions, self-study and mentorship.

This meeting will take place by webinar. Registration is required to participate.

Date: September 13, 2017

Time: 12:00pm - 1:00pm Pacific Time

Location: Webinar

Registration: http://caot.ca/viewEvent.html?no_header=true&productId=9771

Cost:

Free for CAOT-BC members

$15 for non-members

If you have any questions about registration please contact Sarah Slocombe: sslocombe@caot.ca

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CAOT-BC Dysphagia Practice Network Meeting: March 28, 2017

Topic: The Regional Dysphagia Management Team (RDMT), established as a Northern Health resource to build local capacity for managing eating, drinking and swallowing problems for adults, primarily with a complex care focus. Join Judy Wakabayashi (OT), Kate Cooke (Administrative Assistant), Olivia Jebbink (RD) and Julie Lidstone (SLP) and to learn more about this initiative.

This meeting will take place by webinar. Registration is required to participate.

Date: March 28, 2017

Time: 12:00pm – 1:00pm Pacific Time

Location: Webinar

Registration: https://www.caot.ca/store/events/registration.aspx?event=SIG28MAR17

Cost:

Free for CAOT-BC members

$15 for non-members

Registration takes only a minute in a few easy steps:

1. Click on registration link
2. Log in to your profile
3. Click "Register"
4. Click "Add to Cart"
5. Click "My Cart"
6. Click "Pay Now"
7. Click "Place Order"

You will receive a confirmation letter immediately after completing your online registration. Please check your spam/junk box, as sometimes these letters can be filtered out of regular email. If you still do not receive a confirmation after completing all the steps, please email caotbc@caot.ca for additional support.

If you have any questions please contact Sarah Slocombe: sslocombe@caot.ca

Dysphagia Practice Network Meeting: May 9th, 2016

TOPIC: Updates from inter-professional conference and IDDSI project

This meeting will take place by teleconference. Registration is required to participate.

Date: May 9th, 2016

Time: 12:00pm – 1:00pm Pacific Time

Location: Teleconference

Registration: https://www.caot.ca/store/events/registration.aspx?event=SIG9MAY16

Cost:

Free for CAOT-BC members

$15 for non-members

Registration takes only a minute in a few easy steps:

1. Click on registration link
2. Log in to your profile
3. Click "Register"
4. Click "Add to Cart"
5. Click "My Cart"
6. Click "Checkout"
7. Click "Place Order"

You will receive a confirmation letter immediately after completing your online registration. Please check your spam/junk box, as sometimes these letters can be filtered out of regular email. If you still do not receive a confirmation after completing all the steps, please email caotbc@caot.ca for additional support.

If you have any questions please contact Sarah Slocombe: sslocombe@caot.ca

Dysphagia Workshop

Introduction to the Assessment and Management of Eating, Drinking and Swallowing Disorders: A Clinical Approach

Dates: Thursday April 28 and Friday April 29, 2016

Location: The Italian Cultural Centre, 3075 Slocan Street, Vancouver

This is a two day introductory level course in the clinical management of eating, drinking and swallowing disorders. Video clips and case studies will be used and will include various population groups. Please refer to the PDF forfull course description and registration form or contact:  jenny@accesstherapists.com  

Interprofessional Approaches to Dyshagia Management

WHEN:    October 4-6, 2015

WHERE:  Toronto

The Canadian Association of Occupational Therapists (CAOT), Dietitians of Canada (DC) and Speech-Language and Audiology Canada (SAC) are pleased to offer this interprofessional workshop intended for experienced clinicians seeking to advance their knowledge and skills in dysphagia assessment and management.

The workshop will delve into areas of practice that may take you out of your comfort zone, challenge your assumptions and help you realize the power and benefits of interprofessional practice. The workshop has been specifically designed to engage clinicians from different disciplines so that we may all learn more about the areas of expertise and skills our colleagues bring to the table when discussing challenging cases. If you are interested in honing your clinical skills and taking your team contributions to the next level, this workshop is for you.

REGISTRATION INFORMATION

CAOT-BC Dysphagia Special Interest Group Meeting: April 14, 2015

When:  

April 14, 2015
4:00-5:30pm

Where:

Teleconference

RSVP:  

Email: caotbc@caot.ca 

Cost:

Free for CAOT-BC members

$15 for non-members-email caotbc@caot.ca to pre-register

CAOT-BC Dysphagia Special Interest Group meeting: January 13, 2015

When:  

January 13, 2015
4:00-5:30pm

Where:

Teleconference

RSVP:  

Email: caotbc@caot.ca 

Cost:

Free for CAOT-BC members

$15 for non-members-email caotbc@caot.ca to pre-register

CAOT-BC Dysphagia SIG Meeting: September 24, 2014

When:  

September 24, 2014
4:00-5:30pm

Where:

Teleconference

RSVP:  

Email: caotbc@caot.ca 

Cost:

Free for CAOT-BC members

$15 for non-members-email caotbc@caot.ca to pre-register

Extension of the IDDSI Surveys

The International Dysphagia Diet Standardisation Initiative www.iddsi.org aims to develop global standardisation for terminology and definitions used for texture modified foods and thickened liquids for individuals with dysphagia of all ages, in all care settings, and all cultures to improve patient care and safety.

We are happy to announce the completion of Stage 1 of the initiative.  An open access manuscript, The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative, is now available in the August 2013 Current Physical Medicine and Rehabilitation Reports. http://tinyurl.com/q54terf

As we begin  Stage 2 of the initiative, a systematic literature review is currently being conducted by several international sites to determine evidence for, and definitions from publications for texture modified foods and thickened liquids.

In conjunction with the literature review, IDDSI would like to invite your input into what is needed for global standardised terms.  Please take a moment to complete and disseminate the following surveys:

Survey for Health Professionals & Food Services https://www.surveymonkey.com/s/2GJXTDV

Survey for Patients, Carers & Support Organizations https://www.surveymonkey.com/s/6DQJDBG

Survey for Industry Partners https://www.surveymonkey.com/s/26G2JTJ

Survey for Researchers -https://www.surveymonkey.com/s/26KDKQ5 

Please complete the survey relevant to your situation by February 14, 2014.  Your input is most valued and will contribute to improving quality care and safety for individuals managing with dysphagia.

To be kept updated about future updates and be invited for future consultations, please register on the IDDSI website www.iddsi.org 

Workshop: Introduction to the Assessment and Management of Eating, Drinking and Swallowing Disorders: A Clinical Approach

WHEN:February 28 and March 1, 2014

WHERE: The Italian Cultural Centre, 3075 Slocan Street, Vancouver.

DESCRIPTION: Hosted by Access Community Therapists, this is a two day introductory level course in the clinical management of eating, drinking and swallowing disorders. Video clips and case studies will be used and will include various population groups.

Download the PDF for full course description and registration form or contact katie@accesstherapists.com   

Update: The International Dysphagia Diet Standardisation Iniative

The International Dysphagia Diet Standardisation Initiative is pleased to announce that they have concluded Stage 1 of the initiative.

They are proud to share with you the open access link to their first publication titled:

The Need for International Terminology and Definitions for Texture-Modified Foods and Thickened Liquids Used in Dysphagia Management: Foundations of a Global Initiative

(published in Current Physical Medicine and Rehabilitation Reports in August 2013).  

The International Dysphagia Diet Standardisation Initiative

In June 2012, an international group of clinicians, researchers, food scientists and industry involved in the provision of care for people with eating, drinking and swallowing difficulties (dysphagia), met to discuss the possibility of developing international descriptors and definitions for the foods and drinks used in dysphagia practice.  The underlying rationale for such an initiative is that a common understanding of dysphagia diet terminology can improve communication between clinicians and improve safety for clients.  Regional and national standards have been developed in several countries, notably England and Australia, in response to severe harm caused by a misunderstanding of diet terminology between clinicians.

Difficulty with eating, drinking and swallowing occurs in all ages and populations and Occupational Therapists are often involved in addressing these issues.

The International Dysphagia Diet Standardisation Initiative (IDDSI) asks "Wouldn't it be nice if we all understood each other?" and to imagine if we all used the same terms for texture modified foods and thickened liquids. The IDDSI invites you to participate in a survey to assist in reaching this goal. 

OT’s interested in being informed/updated and/or participating in this initiative are invited to contact Janice Duivestein for more information. You can also review the IDDSI project plan.