The science of healthcare delivery is a young field, and when the inaugural International Tracheostomy Symposium (ITS) was convened in Melbourne, Australia in 2011, team-oriented approaches to tracheostomy were still in their infancy. While clinicians around the world had been witnessing how fragmented care predisposed to tracheostomy-related adverse events, there was little consensus on how fix the problem.
The last decade has witnessed unprecedented progress in our understanding and management of tracheostomy care. Beginning in 2011, several landmark studies and audits on tracheostomy-related harm became a clarion call for improving the prevailing standard of care. Data revealed that in intensive care units, tracheostomyrelated incidents accounted for up to half of all airway-related deaths and hypoxic brain injuries.
In 2004, a multidisciplinary team (MDT) tracheostomy care model was developed to care for patients with a tracheostomy who were outside of the intensive care setting. The three main components of the MDT care model are: a tracheostomy care bundle checklist, an educational program for staff on the dedicated wards where patients with a tracheostomy are cared for and a dedicated MDT who attend a weekly tracheostomy ward round. We have critically reviewed how the care model is currently working to reassess its effectiveness. In addition, we have looked at the financial savings brought about by the reduction in length of stay in the high dependency setting.
Patients with tracheostomies and their families can experience delays and frustration with care, compounded if systems are inconsistent, uncoordinated or ineffective. Improving Tracheostomy Care (ITC) is a three-year Quality Improvement (QI) programme guiding the implementation of the Global Tracheostomy Collaborative’s (GTC) resources into 20 diverse UK sites to address patient satisfaction. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is a patient satisfaction survey used in both the United States and the NHS to describe the patient experience. The aim of this study was to evaluate the internal consistency (reliability) of HCAHPS in this setting.