NOMS and Its Role in Dysphagia Management In recent years, the term “outcomes” has become a very hot topic in all works settings, especially in health care. Hospital administrators, insurance companies, accreditation organizations, and even public school administrators are particularly interested in “outcomes.” Speech-language pathology is no exception. It is possible that every hospital speech-language pathologist ... Article
Article  |   June 01, 2002
NOMS and Its Role in Dysphagia Management
Author Affiliations & Notes
  • Sally A. Sparks-Walsh
    VA Medical Center, Phoenix, AZ
  • Carl T. Hayden
    VA Medical Center, Phoenix, AZ
Article Information
Swallowing, Dysphagia & Feeding Disorders / Articles
Article   |   June 01, 2002
NOMS and Its Role in Dysphagia Management
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), June 2002, Vol. 11, 20-22. doi:10.1044/sasd11.2.20
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), June 2002, Vol. 11, 20-22. doi:10.1044/sasd11.2.20
In recent years, the term “outcomes” has become a very hot topic in all works settings, especially in health care. Hospital administrators, insurance companies, accreditation organizations, and even public school administrators are particularly interested in “outcomes.” Speech-language pathology is no exception. It is possible that every hospital speech-language pathologist has been asked, at some point in his/her career, to get a patient eating as soon as possible, so they could be discharged home. Working toward that end is an outcome. This article is an attempt to provide a means of obtaining treatment outcome data for dysphagia.
Treatment outcomes have been a concern in rehabilitation for years. The Functional Independence Measure (FIM) was developed in the 1980s to provide a method of quantitatively measuring the abilities of individuals undergoing rehabilitation (Keith, 1987). It was developed by UDSMR (Uniform Data System for Medical Rehabilitation) and is the largest national registry of standardized information on medical rehabilitation inpatients in the United States. While it is considered by most rehabilitation professionals to be the standard, FIM was found to be lacking when it came to addressing communication and swallowing abilities (Frattali, 1998). In October of 1993, ASHA formed the Task Force on Treatment Outcomes and Cost Effectiveness to create a national outcomes database for speech-language pathologists and audiologists. In 1997, the National Center for Treatment Effectiveness in Communication Disorders took over this role. The National Outcomes Measurement Sys-tem—NOMS—was developed to address the needs of speech-language pathologists and audiologists relating to outcome measures. NOMS is a series of seven point rating scales, also know as Functional Communication Measures (FCM), used to measure change in functional communication skills. NOMS also collects information about demographics, medical diagnosis, service delivery model, amount and frequency of services, treatment settings and patient/family satisfaction (ASHA, 1998). Patients are admitted to the NOMS database when they have received a minimum of two treatment sessions. They receive the treatment deemed appropriate by the treating speech-language pathologist and are discharged from NOMS when one of the following occur: treatment goals met; patient progress plateaued; patient discharged from facility (or different setting or level of care within same facility); change in medical condition; insurance would not pay; or, patient would not pay. It is feasible that a patient could be admitted and discharged many times for the same incident, due to changes in medical condition or discharged from facility.
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