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Updated: Jun 30, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
09:52

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

PEAK-II Trach: A Multi-Institutional Quality Improvement/Simulation Study Assessing Pediatric Emergency Readiness

Olivia Dunne1, Amanda Shen1, Roxanna Mosavian1

  • 1Albert Einstein College of Medicine, Bronx, New York, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|June 29, 2026
PubMed

Insights

Pediatric tracheostomy emergencies require rapid team response. In situ simulations identified system weaknesses and team performance variations impacting emergency preparedness, guiding targeted improvements.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Simulation
  • Patient Safety

Background:

  • Pediatric tracheostomy emergencies are critical events demanding swift, coordinated care.
  • Assessing team performance and system factors is crucial for optimizing emergency response.

Purpose of the Study:

  • To evaluate objective team performance during pediatric tracheostomy emergencies using in situ simulation.
  • To identify latent safety threats (LSTs) and resilience supports influencing emergency readiness across various clinical settings.

Main Methods:

  • Conducted in situ simulations of pediatric tracheostomy emergencies in 11 hospitals.
  • Utilized NeoCHART+™ for recording critical action times and structured debriefs for LST identification.
  • Employed multivariable Cox models to analyze predictors of timely critical actions.

Main Results:

  • 77% of teams successfully replaced tracheostomy tubes within 5 minutes.
  • Common LSTs included ventilation issues, unclear leadership, and equipment non-standardization.
  • Respiratory therapists and dedicated tracheostomy teams improved critical action times.

Conclusions:

  • In situ simulation effectively identified system-level LSTs, resilience factors, and performance variability in pediatric tracheostomy emergencies.
  • Findings can inform targeted interventions to enhance pediatric tracheostomy emergency preparedness.
Abstract

Keywords:
healthcare simulationmobile applicationspatient safetyquality improvementtracheostomytracheotomy

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