A 5-year review of a tracheostomy quality improvement initiative: reducing adverse event frequency and severity

Twose, Paul, Cottam, Julia, Jones, Gemma, Lowes, Jennifer and Nunn, Jason 2024. A 5-year review of a tracheostomy quality improvement initiative: reducing adverse event frequency and severity. Otolaryngology - Head and Neck Surgery 10.1002/ohn.736 Item availability restricted.

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Abstract

Objective The number of tracheostomies performed annually in resource-rich countries is estimated at 250,000. While an essential procedure, approximately 20% to 30% of patients will experience at least 1 tracheostomy-related adverse event. Within tracheostomy care and across wider health care environments, quality improvement (QI) programs have been shown to reduce patient harm and improve outcomes. Herein we report on a 5-year long, tracheostomy QI initiative aimed at improving patient experience and reducing the frequency and severity of adverse events. Methods A 5-year (ongoing) QI initiative led by the Cardiff and Vale University Health Board tracheostomy team, within a tertiary, 1000-bedded hospital in South Wales, United Kingdom. The QI initiative has focused on 3 main themes: (1) Education and training; (2) Clinical oversight and decision making; and (3) improved data collection. Data were collected from existing tracheostomy databases. Results Over the past 5 years, we have observed a sustained reduction in both the frequency and severity of adverse events, with less than 1 patient per 100 experiencing a moderate or severe adverse event. This has resulted in improvements in patient experience and a cost reduction of £GBP364,726 per annum. Discussion Our 5-year ongoing tracheostomy QI initiative has resulted in improved outcomes with increased achievement of tracheostomy weaning markers and sustained reductions in both the frequency and severity of adverse events. Implications for Practice A continuous focus on QI is associated with improved patient and service outcomes. These improvements can be spread and scaled to benefit more patients and organizations.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Healthcare Sciences
Publisher:	Wiley
ISSN:	0194-5998
Date of First Compliant Deposit:	9 April 2024
Date of Acceptance:	29 February 2024
Last Modified:	17 Apr 2024 21:21
URI:	https://orca.cardiff.ac.uk/id/eprint/167845

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