Pediatric tracheostomy speaking valves: A multidisciplinary protocol leads to earlier initial trials

Area of Science:

• Pediatric Otolaryngology
• Speech-Language Pathology
• Healthcare Protocol Implementation

Background:

• Early speaking valve use in pediatric tracheostomies is crucial for language development.
• The impact of institutional protocols on speaking valve trial timelines is not well-documented.
• Existing literature lacks data on how protocols affect patient populations and trial durations.

Purpose of the Study:

• To evaluate the effect of an institutional multidisciplinary protocol on speaking valve trial timelines in pediatric patients.
• To compare patient characteristics and timelines before and after protocol implementation.
• To analyze speaking valve trial timelines across different tracheostomy classifications.

Main Methods:

• Retrospective study analyzing 12 years of data at a pediatric quaternary hospital.
• Collected data on timelines (tracheostomy insertion, SLP consultation, speaking valve order, trial) and patient characteristics.
• Compared timelines before and after protocol institution and across tracheostomy classifications using medians (IQRs).

Main Results:

• Median time from tracheostomy insertion to SLP consultation remained unchanged (1.8 months).
• Median time from tracheostomy insertion to speaking valve trial significantly decreased post-protocol (34.1 to 12.9 months).
• Time to speaking valve trial did not differ significantly between tracheostomy classifications (upper airway obstruction, complex medical condition, invasive ventilation).

Conclusions:

• An institutional multidisciplinary protocol effectively reduces the time to speaking valve trials in pediatric patients.
• Protocol implementation benefits all pediatric patients with tracheostomies, irrespective of the underlying reason.
• Further research may explore specific protocol components contributing to timeline improvements.