Improving Patient Outcomes and Reducing Readmissions with Mobile FEES

For hospitals and skilled nursing facilities (SNFs), the path to reducing readmission rates often begins with a frequently overlooked factor: accurate swallow function assessment.

Improving patient outcomes and reducing readmissions with mobile FEES starts with one core idea: faster, instrumentally confirmed dysphagia diagnosis at the bedside prevents missed aspiration, supports safer diets, and allows earlier, more targeted interventions. This approach directly lowers the risk of aspiration pneumonia and
90‑day rehospitalizations.

Mobile FEES brings a gold‑standard swallow study directly to high‑risk patients, avoiding delays and transport barriers that often leave dysphagia under‑recognized at discharge.

Why Dysphagia Drives Readmissions
Dysphagia is more than a symptom; it is a critical driver of patient decline in older adults, post-stroke patients, and medically complex populations.
Dysphagia prevalence remains high in these groups, yet it often goes undiagnosed until complications arise.

When swallowing disorders are unrecognized or undertreated, they significantly increase the risk of malnutrition, dehydration, and aspiration pneumonia, a primary cause of unplanned hospital readmissions. Timely, accurate, bedside dysphagia diagnosis using mobile FEES is a practical, evidence-based way for facilities to break this cycle and improve long-term outcomes.

The High Cost of Missed Dysphagia
The correlation between swallowing deficits and hospital returns is well-documented. Evidence suggests that dysphagia significantly increases
pneumonia-related readmissions and mortality, with rates markedly higher in patients with confirmed swallowing problems compared to those without.

New data highlights the importance of predischarge assessment, linking
dysphagia scores (such as EAT-10) to higher 90-day aspiration pneumonia and readmission rates if issues are not addressed before the patient leaves care. Reliance on robust bedside screening alone has limitations; clinical exams often fail to detect silent aspiration or subtle pharyngeal phase problems that can only be identified through instrumental imaging.

Why Instrumental Imaging Matters
To effectively manage dysphagia, clinicians must look beyond the bedside screen. While clinical swallow evaluations are valuable screening tools, they cannot visualize the airway or the pharyngeal phase of the swallow.

Instrumental tests, specifically Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Videofluoroscopic Swallow Studies (VFSS), provide the objective data necessary to define
swallowing function and safety. These tools visualize aspiration, penetration, and residue patterns that drive targeted care plans.

Among instrumental options, FEES is increasingly preferred for medically fragile patients. It involves no radiation, has no time constraints (allowing for fatigue testing), and offers direct laryngeal visualization during the consumption of real food in a natural eating position.
Often this diagnostic study results in diet upgrades for patients, allowing them to enjoy a larger variety of foods and improved outcomes in the facility.

What Makes Mobile FEES Different
Mobile FEES is a portable service that brings endoscopic swallow assessments directly to the patient’s bedside in hospitals, SNFs, LTACHs, and rehab facilities. This model solves the logistical challenges inherent in traditional hospital-based radiology.

• Logistical Advantages: Eliminates the need for transport to radiology, reduces delays, and improves access for non-ambulatory or oxygen-dependent patients.
• Infection Control: Performing a short, endoscopic exam in the patient’s familiar care setting minimizes exposure risks associated with moving frail patients through a hospital.
• Flexibility: Mobile providers often offer easier scheduling for weekend or after-hours consults, preventing valid discharge delays.

Clinical Benefits: From Bedside Exam to Better Care Plans
The primary value of mobile FEES lies in its ability to allow Speech-Language Pathologists (SLPs) and physicians to directly visualize aspiration, penetration, secretion management, and
bolus flow issues in real time. These patterns are strong predictors of aspiration pneumonia risk.

By visualizing residue, timing, and airway protection, the care team can make precise recommendations regarding:

• Diet consistency and liquid thickness.
• Compensatory strategies and positioning.
• Therapy targets.
• The necessity of enteral support versus the ability to safely maintain or upgrade oral intake.

Impact on Aspiration Pneumonia and Complications
Instrumental identification of aspiration and laryngeal penetration is critical, as these findings are associated with a
higher risk of aspiration pneumonia across adult populations.

Research demonstrates that structured dysphagia programs, particularly those paired with objective assessment, help prevent complications by rapidly identifying high-risk patients. This allows for tighter NPO decisions when necessary, while simultaneously supporting appropriate diet liberalization for lower-risk patients, preventing unnecessary dietary restrictions.

Reducing Readmissions Through Timely Diagnosis
Untreated or poorly characterized dysphagia at discharge is a silent liability. Data links these unresolved issues to higher 90-day readmission rates, underscoring the urgent need for robust predischarge assessment.

Mobile FEES integrates seamlessly into readmission-reduction strategies and value-based care initiatives. By providing same-day or rapid-turnaround diagnostics, mobile FEES helps teams finalize safer discharge plans, ensuring patients are sent home or to the next level of care with appropriate diet orders, supervision levels, and therapy plans in place.

Operational and Financial Advantages for Facilities
Beyond clinical outcomes, adopting mobile FEES offers significant operational gains. Facilities experience less staff downtime related to patient transport and fewer canceled or delayed studies. This results in better throughput for high-yield units such as stroke wards and ICU step-downs.

FEES is significantly cheaper (20% of the cost) than a traditional Modified Barium Swallow Study. For patients under consolidated billing, this results in large savings to the facility.

Financially, preventing aspiration events and pneumonia readmissions reduces penalties under readmission metrics and lowers the overall cost of care. Furthermore, utilizing mobile FEES services converts what is traditionally a large capital and staffing burden—owning endoscopy and fluoroscopy equipment—into a predictable, billable service partnership.

Implementation: Bringing Mobile FEES to Your Bedside
Implementing a mobile FEES program is designed to be seamless. The workflow typically involves a physician or SLP consult, followed by the bedside exam, immediate interpretation, and same-day recommendations incorporated into the Electronic Health Record (EHR).

Successful implementation relies on collaboration. SLPs and other trained providers perform the exam within their scope of practice, while nursing and dietary services adjust care plans based on the findings. Facilities can maximize impact by creating screening pathways that trigger mobile FEES and by tracking key metrics, such as pneumonia rates and diet upgrades.

Unrecognized dysphagia drives aspiration pneumonia and avoidable readmissions, but timely, accurate bedside diagnosis with mobile FEES changes the trajectory for high-risk patients. It offers a dual benefit: improved patient safety and quality of life, alongside operational and financial stability for hospitals and skilled nursing facilities.

Ready to improve your facility’s outcomes?
Contact Diagnostech today to review your current readmission data and design a bedside dysphagia pathway tailored to your patient population.