SHM Converge Scientific Abstract ePoster Gallery-Implementation of a Hospitalist-Led Multidisciplinary Tracheostomy Care Team

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This project describes a hospitalist-led multidisciplinary tracheostomy care team at Duke University Hospital designed to improve inpatient management of patients with tracheostomies, support discharge planning, and increase decannulation when appropriate.<br /><br />The need for the intervention was driven by long hospital stays, frequent complications, and inconsistent provider comfort with tracheostomy care, especially decannulation. In FY23, general medicine patients with trachs had an average length of stay of 41 days, and chronic trach patients were often difficult to discharge to home or facility. National guidelines recommend a multidisciplinary approach for hospitalized adults with tracheostomies.<br /><br />Beginning in January 2024, the team began meeting virtually once per week. It included hospitalists, respiratory therapists, and speech-language pathologists. The group reviewed all admitted general medicine patients with trachs, discussed barriers to discharge, evaluated candidacy for decannulation, and recommended next steps such as speaking valve use and capping trials. The hospitalist then communicated recommendations to the primary team. The project also included tracheostomy education for residents and hospitalists.<br /><br />In 2024, 59 unique patients were reviewed over 79 encounters. Nineteen patients (32%) were decannulated before discharge, compared with 12 of 79 patients (15%) in FY23, suggesting an early improvement in decannulation rates. Median length of stay also improved overall, from 20.9 days in FY23 to 17.8 days in CY2024. Patients who were not decannulated had a notably shorter median LOS in CY2024 than in FY23.<br /><br />The authors conclude that a hospitalist-led multidisciplinary tracheostomy team may improve inpatient trach care and decannulation outcomes, and the model may be expanded to other services such as neurology and trauma.

Asset Subtitle

Jesse Rhodes

Meta Tag

Author List Alyssa Platt, Jesse Rhodes, Michelle Perkons, Noppon P. Setji

Category Innovations

Concept Tracheostomy Care

Concept Decannulation

Concept Multidisciplinary Team

Concept Capping Trial

Concept Length of Stay

Distinguished Non-Finalist

Presenter Organization Duke University Hospital

Presenting Author Jesse Rhodes

Track Quality Improvement

Keywords

tracheostomy care

multidisciplinary team

hospitalist-led

decannulation

discharge planning

length of stay

respiratory therapy

speech-language pathology

inpatient management

patient outcomes

Tracheostomy Care

Decannulation

Multidisciplinary Team

Capping Trial

Length of Stay