Improving tracheostomy care: collaborative national consensus and prioritisation of quality improvements in the United Kingdom
Main Article Content
Abstract
Background
Tracheostomies are artificial airway devices used predominantly to manage airway obstruction and to facilitate weaning from prolonged mechanical ventilation. Whilst a lifesaving procedure, tracheostomy can also lead to significant morbidity and mortality. Associated vocalization and swallowing problems lead to anxiety for patients, families and healthcare staff. The Global Tracheostomy (Quality Improvement) Collaborative can improve the safety and quality of care in participating institutions, leading to a large-scale UK-wide evaluation. However, whilst individual strategies have proved effective in single centres, it is unclear which tracheostomy quality improvement program elements should be prioritized in the UK’s National Health Service’s (NHS) diverse hospitals.
Aims
Through a unique consensus and prioritisation exercise using front line staff and leaders from 20 participating UK hospitals, we aimed to develop a national strategy for tracheostomy quality improvements.
Methods
Following national research ethics committee approval, representative multidisciplinary staff groups were interviewed and completed bespoke questionnaires regarding their experiences of tracheostomy care and associated quality improvements. Qualitative evaluation techniques were applied to develop key themes, further refined by group consensus and prioritisation exercises, creating a ranked list of important quality improvement interventions that should be implemented.
Results
Thematic analysis yielded 22 statements regarding tracheostomy care. Highly ranked priority interventions included multidisciplinary staff education, standards and competencies, multidisciplinary ward rounds, equipment standardisation and structured care bundles.
Conclusion
Prioritising distinct quality improvement interventions will allow providers to focus on improving the quality and safety of tracheostomy care using resources and strategies that are important to frontline healthcare staff.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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