Standardized Tracheostomy Education Across the Enterprise

Area of Science:

• Pediatric Healthcare Quality Improvement
• Tracheostomy Management
• Patient Safety Initiatives

Background:

• Tracheostomy care requires specialized knowledge and consistent protocols.
• Variations in care and discharge planning can lead to adverse events, including readmissions.
• A need existed to standardize tracheostomy management across a large pediatric hospital system.

Purpose of the Study:

• To establish a Tracheostomy Subject Matter Expert (Trach SME) Committee.
• To standardize tracheostomy care, education, and discharge processes enterprise-wide.
• To improve patient outcomes and reduce readmission rates for tracheostomy patients.

Main Methods:

• Formation of a Trach SME Committee at Boston Children's Hospital.
• Evaluation and standardization of discharge processes across all hospital units and satellites.
• Centralization of education materials and revision of policies to align with best practices.
• Training of unit-based Trach Champions to disseminate knowledge and provide unit-level support.

Main Results:

• The 7-day unplanned readmission rate for tracheostomy patients decreased from 18.18% to 0% over three years (2014-2016).
• The 30-day unplanned readmission rate was introduced in 2015 at 6.67% and reduced to 0% by 2016.
• Successful implementation of standardized protocols and education led to a significant reduction in readmissions.

Conclusions:

• Standardization of tracheostomy care policies, procedures, and caregiver education is effective.
• A multidisciplinary committee approach can successfully drive quality improvement in complex pediatric care.
• Improved tracheostomy management directly correlates with reduced hospital readmissions and enhanced patient safety.