Valves for the Voiceless: Time to Speaking Valve Use in Posttracheostomy Patients After Multidisciplinary Initiative

Area of Science:

• Tracheostomy care
• Speech-language pathology
• Medical quality improvement

Background:

• Speaking valve (SV) use is crucial for post-tracheostomy rehabilitation.
• Standardized protocols are needed to optimize SV implementation.
• A multidisciplinary approach can enhance patient outcomes.

Purpose of the Study:

• To evaluate the impact of a multidisciplinary team's new protocols on SV use.
• To determine if protocol implementation decreased the time to SV trials.
• To assess changes in SV trial success rates.

Main Methods:

• Retrospective case series of 421 tracheostomy patients (2017-2023).
• Comparison of SV use and time to trial before and after 2019 protocol implementation.
• Interrupted time series analysis to assess protocol impact on time to SV placement.

Main Results:

• Eligible patients receiving an SV trial increased from 75% to 95%.
• First-attempt SV tolerance improved from 60% to 75%.
• Protocol implementation was associated with an 80% decrease in time to SV placement.

Conclusions:

• Multidisciplinary protocols standardize post-operative tracheostomy care.
• Algorithms for speech-language pathologist (SLP) consultation and SV use are effective.
• Addressing barriers like tracheal pressures and patient participation can further optimize SV use.