Improved Ventilator Weaning and Decannulation Outcomes with Enhanced Staffing Model

Introduction: Provider continuity can improve many aspects of an inpatient stay however, there is little data on whether it could affect mechanical ventilation weaning and tracheostomy decannulation. This study evaluated whether provider continuity could increase mechanical ventilation weaning and decannulation rates in the inpatient setting. Methods: Data was collected retrospectively from April 2020 to May 2022 for patients admitted to a pulmonary stepdown unit (SDU). A new staffing model was started in February 2021, in which a small group of physicians and advanced practice providers (APPs) continuously rotated through the unit. Ventilator weaning and decannulation protocols were used before and after initiating the new staffing model. Results: A total of 185 patients were reviewed and included in the study. During the 2‑year timeframe, 46% of the patients were weaned off the ventilator (n = 86), with 26% of the patients weaned occurring before the staffing model (n = 22) and 74% of patients weaned after (n = 64). Of the patients weaned from the ventilator, 56% were decannulated (n = 48), with 10% occurring before the staffing model started (n = 5) and 90% occurring afterward (n = 43). The increase in patients weaned from the ventilator and decannulated after the staffing model was statistically significant (P = 0.01 and P = 0.001, respectively). Conclusion: There was a significant increase in both mechanical ventilator weaning and decannulation rates after initiating the new staffing model. This study shows how continuity of care can have a positive effect on mechanical ventilation weaning and decannulation rates in the inpatient setting.