Multidisciplinary Tracheostomy Teams Reduce Emergency Department Utilization in Pediatric Patients: A Retrospective...

Area of Science:

• Pediatric Pulmonology
• Healthcare Management
• Quality Improvement

Background:

• Pediatric patients with tracheostomy often require frequent emergency department (ED) visits.
• Optimizing care for these vulnerable patients is crucial for reducing healthcare utilization and improving outcomes.

Purpose of the Study:

• To evaluate the impact of multidisciplinary tracheostomy team (MDT) interventions on emergency department (ED) utilization in pediatric patients requiring tracheostomy.

Main Methods:

• A retrospective cohort study analyzed data from 364 pediatric patients who underwent tracheostomy between 2015 and 2023.
• Study phases included pre-intervention, post-intervention (pre-COVID), COVID-19, and post-COVID recovery.
• Parametric survival analysis and mixed-effects negative binomial regression were used to analyze ED visit frequency and time to first ED visit.

Main Results:

• MDT implementation correlated with a 50% reduction in ED visit rates in the post-intervention, pre-COVID period.
• This reduction was sustained through the COVID-19 pandemic (65% reduction) and post-COVID recovery (91% reduction).
• Time to the first ED visit significantly increased post-intervention, and respiratory conditions accounted for 34% of ED visits.

Conclusions:

• Multidisciplinary tracheostomy teams (MDTs) effectively reduce emergency department utilization in pediatric patients with tracheostomy.
• The positive impact of MDTs on decreasing ED visits is sustained, even during challenging periods like the COVID-19 pandemic.