ABSTRACT
Background
The International Dysphagia Diet Standardisation Initiative (IDDSI) framework establishes a global standard, with standardized terms, descriptors and measurement criteria, to enhance dysphagia care. This paper presents one of the first documented successful implementations of IDDSI in a large acute care hospital. The implementation at the University Hospital Graz, a 1554-bed acute care facility, took place between 2021 and 2024. The project aimed to standardize practices in five patient-focused areas to improve knowledge, and facilitate multiprofessional communication.
Methods
Based on the IDDSI Monitor, Aware, Prepare, Adopt (MAPA) model and IDDSI implementation guide, a project plan was developed. An interdisciplinary working group consisting of dietitians, Speech-Language Pathologists (SLPs) and chefs conducted comprehensive audits of all existing recipes and aligned clinical swallowing assessments and dietetic recommendations with IDDSI standards. Training programs ensured the consistent application of terminology across the therapeutic, nursing, and kitchen teams. Two staff surveys were conducted – one before and one after implementation.
Results
The working group successfully integrated IDDSI into clinical workflows, menu planning, charting and electronic health record systems. Staff surveys showed a significant increase in IDDSI awareness, rising from 42.1% to 76.7%, along with greater use of the IDDSI standardized terminology by the staff during the project’s duration.
Key implementation challenges included adapting recipes to meet IDDSI texture levels and integrating the framework into the utilized Cook and Chill food preparation system. Dual project lead with one Speech-Language Pathologist (SLP) and one dietitian, targeted training, and the active engagement of kitchen staff were crucial to the project’s success.
Conclusions
This study demonstrates that implementing IDDSI in acute care settings is both feasible and beneficial, leading to multiprofessional knowledge of the framework and fostering collaboration.
Journal of Human Nutrition and Dietetics, Volume 38, Issue 5, October 2025. Read More