Healthcare Providers:
Presence's Mobile FEES Swallow Study Services will visualize your patient's swallow.
What is FEES (Fiberoptic-Endoscopic Examination of Swallowing)?
FEES is a safe, cost-effective alternative to MBS (modified barium swallow studies) which uses an equipment similar to what ENT doctors use.
FEES requires no radiologist or transport. It is cost-effective.
Because radiologists, radiology technicians or the MBS machine are not required, FEES costs a fraction of the cost of MBSs, Because the study is done at your facility, there is no need for ambulances, CNA or the sitter to accompany the patient for hours like the cases of outpatient MBS or FEES.
Mobile FEES requires no transportation. No missed PT/OT, no interruption of care.
Because the study will be conducted at your facility, your patient can participate in physical therapy, occupational therapy, and all other activities they need. No more time lost due to transportation and waiting in the hospital lobby for hours.
Mobile FEES gives you immediate results. This promotes patient and family satisfaction.
We welcome your SLP and MD to be present for the FEES. We offer explanation for the diet recommendations and plan to the parties report the test outcome to the patient's family if you wish for us to do so. We also generate a full written report within 48 hours. I know you value providing the best customer care.
Mobile FEES is a safer choice: No risks for patient fall, dehydration or constipation.
Because FEES is done at bedside in the patient's chair/bed, there is no need to transport the patient from the bed to a gurney, and from the gurney to a test chair, etc. This eliminates the fall risk associated with the swallow exam. Just as important, because FEES does not involve barium, there is no increased risks of constipation or dehydration associated with the test.
Mobile FEES is ideal for a wide-range of patient types.
MBS can be difficult to do on those who are medically fragile, who cannot sit up, who are obese, and many others. If they cannot sit up, your patient's throat may not be visualized in the image and the instances of aspiration may be missed. You may end up with an incomplete, costly exam which did not give you a full picture on your patient swallow. With FEES, your patients may be reclined in bed or in a bariatric bed, or leaned to the side in a wheelchair.
Dear fellow Speech-Language Pathologists
at SNFs, subacute facilities and LTACs,
We hear your frustration.
at SNFs, subacute facilities and LTACs,
We hear your frustration.
We understand clinical swallow assessments can be very challenging.
We can help you visualize your patient swallow.
We can help you visualize your patient swallow.
Case #1
"My patient just came from a hospital, and it's not clear as to why she is on thickened liquids. There is just too much missing information!"
The issue: When you receive a new patient from a hospital, the information often lacks speech therapy reports including the recommended diet consistencies and whether the patient had an instrumental study such as an MBS to be placed on a modified diet.
Our solution: Our mobile FEES service will provide you not only the least restrictive diet for each of your patient, but also the reasons for the dysphagia and the types of swallow exercises, without having to send him back to the hospital for an outpatient instrumental study.
Case #2
"The recent MBS didn't show aspiration. Then why does my patient keep getting pneumonia?"
The issue: While MBSs provide crucial information for many dysphagia cases, they do not capture aspiration of secretions, reflux or fatigue. MBSs are usually conducted while the patient sits up at 90 degrees, which is not a typical position when they eat.
Our solution: Our Mobile FEES will be conducted while replicating your patient’s typical mealtime. She may be comfortably seated in her favorite sofa in the recreation room or in her bed, using lunch tray as trial items at the pace of her usual consumption. We will take time to catch the real “culprit” of her aspiration pneumonia, beyond the solid and liquid consistencies.
Case #3
"I feel it's time that my trach patient starts on a diet but I don't have the mean to rule out silent aspiration."
The issue: Many of your patients with a tracheostomy may have remained NPO at the hospital because of so many reasons. We understand your priority is to safely initiate or advance the diet for your tracheostomy patients by utilizing an instrumental study given the high risk of silent aspiration in this population. We also understand it is not easy to transport patients that are medically fragile for an outpatient procedure. As you know, these patients can fatigue easily and may not be able to participate in the swallow study, and the outpatient study outcome may not be representative of their usual swallow functions.
Our solution: Our Mobile FEES service provides the instrumental studies in the safest and the most comfortable way possible; the study will be completed in their room, cuff deflation will be done by your respiratory team and their overall medical status will be monitored by your medical team. You can choose to be present for the study and direct us with any strategies that seem to improve or worsen their swallow.
Case #4
"My patient finally had an outpatient MBS and came back with little or no information!"
The issue: The hospital speech pathologists can be overbooked to see patients in multiple units, which can cause delays or disruption in the verbal or written report following an outpatient MBS. Also, if they are not familiar with your patients’ history and eating habits, they may try consistencies or compensatory strategies that are not very informative or helpful. You may sometimes receive the radiologist’s written summary but not the SLP report, which focuses on the patient’s anatomy more than the pathophysiology of his swallow function. After weeks of waiting for this appointment, you are left with almost no information.
Our solution: Because our mobile FEES will be conducted at your facility, you may choose to schedule the study during your speech therapy session with your patient, and you may tell us how you would like the study to be done or you may let us make suggestions, depending on your needs. We will narrate your patient’s swallow as we conduct the study in front of you or the family if you wish. We will let you know of the diet and exercise recommendations upon completion of the study, and provide you with a full written report within 48 hours following the study.
Presence Speech Therapy Mobile FEES
Our Services: Easy 4 Steps
Tell us about your patient, and we will do the rest.
STEP 1
Free Consultation: Tell us about your patients.
Thorough patient interview, imaging reviews and clinical swallow evaluation are crucial to conduct a FEES which ensures the least restrictive and the safest diet. We will perform patient and caregiver interviews prior to the FEES study.
STEP 2
We will perform FEES Exam. The facility SLP can lead or observe.
Based on the interviews and the clinical swallow evaluation, we will conduct a FEES exam of PO trials in the appropriate order. We will determine not only the least restrictive diet but also effective compensatory strategies specific to your patient, such as chin tuck, head turn, and effortful swallows. Facility SLP may choose to be present during the study and make suggestions/ask questions.
STEP 3
We will let you know the FEES results as soon as the study is complete.
We will inform you the FEES results, diet recommendations and therapy plans upon completion of the study. We will review the FEES recording with the facility SLP/ patient/ family/staff upon request at no additional charge.
We will explain the test results in a simple way, often with a diagram to help everyone understand the recommendations.
STEP 4
We will submit a full report in 48 hours + free ongoing consultation for the case.
We will write a comprehensive report consisting of:
Summary of the study for the physician
Laryngeal anatomy and function
Details of each trial for the facility SLP
Recommendations for diet and exercises
And more.
We will submit the report to you within 48 hours. We also offer a phone call to the ordering physician and/or the family upon request.