Purpose: Videofluoroscopic swallowing studies (VFSSs) are critical for diagnosing and managing dysphagia, yet access varies widely across clinical settings. Delayed access may contribute to poor outcomes, including aspiration-related complications. This study aimed to document rates of on-site VFSS access, characterize access barriers, and describe perceived consequences of delays among speech-language pathologists (SLPs) in the United States and Canada. Method: A cross-sectional online survey was distributed over 2 months to SLPs managing patients with dysphagia. Quantitative and qualitative data were collected. Descriptive statistics summarized quantitative responses; thematic analysis was applied to open-ended responses. Results: A total of 344 SLPs responded. Among those using VFSS ( n = 312), 73% reported on-site access. Access was highest in acute care (91%) but markedly lower in skilled nursing (18%) and home health (11%). Rural clinicians reported lower access (63%) and longer wait times. While nearly half of acute care respondents reported VFSS access within 1–2 days, 16% of subacute respondents reported wait times exceeding 1 month. The most frequently cited barriers were limited appointment availability (64%) and transportation logistics (32%), with additional themes from open-ended responses including staffing shortages (36%) and restrictive administrative policies (26%). Nearly 40% of respondents believed delayed access placed patients at risk, and only 20% felt confident making diet recommendations without imaging data. Conclusions: SLPs across settings face appreciable barriers to timely VFSS access, with the greatest limitations in subacute and rural care environments. These findings underscore a critical gap in dysphagia care and the need for systemic solutions, including enhanced infrastructure, staffing, and interdisciplinary collaboration, to ensure equitable access to imaging evaluations of swallowing.
Krekeler et al. (Wed,) studied this question.