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Pediatric Tracheostomy Outcomes After Development of a Multidisciplinary Airway Team: A Quality Improvement

Stephen R Chorney1,2, Ashley F Brown1, Rebecca L Brooks1

  • 1Children's Health Airway Management Program, Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, USA.

OTO Open
|October 7, 2021
PubMed

Insights

A multidisciplinary tracheostomy team improved care for children, reducing education time and length of hospital stay. This airway management program positively impacted tracheostomy processes and outcomes.

Area of Science:

  • Pediatric critical care
  • Surgical outcomes
  • Healthcare management

Background:

  • Tracheostomy care in children requires multidisciplinary coordination.
  • Optimizing length of stay and cost is crucial for pediatric patient management.
  • Existing care models may not fully address the complexities of pediatric tracheostomies.

Purpose of the Study:

  • To evaluate the impact of a multidisciplinary tracheostomy team on length of stay and associated costs.
  • To assess the effectiveness of a structured airway management program in pediatric tracheostomy care.
  • To identify key performance improvements in tracheostomy patient management.

Main Methods:

  • Implementation of an airway management program with a balanced scorecard for performance tracking.
  • Interventions included standardized care, weekly rounding, and enhanced caregiver education.
  • Analysis of process measures (e.g., time to education, consultation rates) and outcome measures (e.g., length of stay, cost, readmissions).

Main Results:

  • Significant reduction in mean time to first education (13.7 to 1.9 days) and increased consultation rates (speech-language pathology: 68% to 95%; pretracheostomy team: 14% to 93%).
  • Mean length of stay decreased significantly (133 to 96 days; P = .006).
  • 30-day readmission rates remained stable (18%); cost analysis showed reductions for shorter admissions.

Conclusions:

  • A multidisciplinary tracheostomy team improves quality metrics and significantly reduces mean length of stay in pediatric patients.
  • The established airway management program positively influences tracheostomy processes and patient outcomes.
  • Cost reductions are estimated for patients with shorter hospitalizations due to improved care coordination.
Abstract

Keywords:
multidisciplinary teampediatric tracheostomyquality improvement initiative

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