Improving the quality of tracheostomy care

Abstract

Educational aimsTo understand the current challenges in the care of tracheostomy patientsTo understand principles of quality improvement collaboration and how this can improve the quality of care for tracheostomy patientsSummaryThe UK National Confidential Enquiry into Patient Outcomes and Death illustrates that there remains significant morbidity and mortality relating to patients with a tracheostomy, with much preventable harm. Challenges include the inherent complexity of the patient's underlying condition, wide variations in tracheostomy management, variable delivery of education for staff, patients and families, and difficult coordination of care between such a variety of individuals involved in performing, managing and ultimately removing tracheostomies.Quality-improvement collaboratives are groups of institutions with a common purpose who work together to drive positive change. They help support clinicians in developing skills and teams necessary to design and sustain quality-improvement cycles. They are a cost-effective way of rapidly disseminating improvement strategies and engaging in shared learning across institutions around the world. The Global Tracheostomy Collaborative aims to improve quality of care and outcomes through five interdependent key drivers: coordinated multidisciplinary team care, education, institution-wide protocols, family and patient-centred care, and metrics and outcomes using a specifically designed database.

Multidisciplinary Tracheostomy Quality Improvement in the COVID-19 Pandemic: Building a Global Learning Community

“… 6 - 10 The Global Tracheostomy Collaborative (GTC), whose mission is to improve lives of individuals with tracheostomy, 4 has spearheaded data collection efforts and dissemination of best practice. 11 , 12 Yet, little is known about effectiveness of virtual approaches for engaging professionals of different disciplines. In the era of COVID-19, the stakes are greatly increased, as healthcare workers have risk of infectious transmission from aerosol generating procedures and routine care related to tracheostomy.…”

Key priority areas for patient safety improvement strategy in Libya: a protocol for a modified Delphi study

“…For patient safety to be truly global, and as highlighted by the Institute of Medicine, low-income and middle-income countries need to be included in the patient safety community. 30 Thus, it could be argued that over the coming 15 years, harm reductions are likely to come from these countries. More importantly, there is a need to ensure that those tools which have been developed in high-income countries can also be developed in low-income countries.…”

Improving patient safety culture through low cost innovation

“…An underlying challenge to improving the quality and safety tracheostomy care lies in the fact that tracheostomy care requires input from many clinical disciplines -for example, the team performing the procedure may well be different to the team responsible for subsequent management. 147 Furthermore, patients often need care in specialised settings that are not always adequately trained and supported in delivering safe tracheostomy care. Lastly, few institutions collect data on tracheostomy outcomes which can make identifying the scale and nature of problems difficult.…”