<h3>Research Objectives</h3> To examine the effectiveness of a multimodal implementation strategy to improve patient care and adherence related to swallowing disorders by measuring adherence to recommended treatment protocols. <h3>Design</h3> Retrospective analysis of data entered by speech-language pathologists (SLPs) collected through a quality improvement program. <h3>Setting</h3> VA Primary Care Facilities. <h3>Participants</h3> 29 SLPs across 15 national VA facilities390 patients followed through a dysphagia treatment program. <h3>Interventions</h3> SLPs participated in a guided implementation process over 5 years consisting of a dedicated program manager, routine site calls to address implementation barriers, and a web-based centralized database allowing local data entry (VA REDCap).Patient participants were followed through an intensive dysphagia swallowing treatment program utilizing evidence-based Interventions: Lingual strengthening (LS) and expiratory muscle strength training (EMST). Patients received regular follow-up with SLPs who reported patient adherence to the recommended follow-up timeline. <h3>Main Outcome Measures</h3> SLP adherence was determined by number of visits entered in REDCap per patient as a percentage of prescribed number of visits for the given protocol.Patients were considered adherent if they 1) completed at least 2 follow-up appointments per their prescribed protocol and 2) completed a final visit at the end of the full exercise program (8 weeks for LS, 6 weeks for EMST). These criteria were used to calculate number of patients who were "adherent" versus "non-adherent". <h3>Results</h3> Since 2013, 390 patients have participated in the IDT program (338 LS, 52 EMST). Patient adherence was 64% (63% LS, 68% EMST). SLPs entered data for 85% of prescribed visits (84% LS, 87% EMST). Barriers to adherence noted during site calls included time required for data entry and inconsistent/inadequate staffing for follow-up visits. <h3>Conclusions</h3> These findings highlight an effective multimodal implementation strategy for investigators or healthcare systems interested in standardizing intensive dysphagia treatment across multiple sites. Overall, patient adherence levels regardless of therapy approach were higher than those reported in prior studies of adherence to dysphagia therapy. Future research will focus on developing behavioral or systems-based interventions targeting barriers underlying the remaining adherence gaps. <h3>Author(s) Disclosures</h3> No disclosures.