SHM Converge Scientific Abstract ePoster Gallery-Improved Ventilator Weaning Outcomes With Enhanced Staffing Model

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This study examined whether provider continuity improves ventilator weaning outcomes in an inpatient pulmonary stepdown unit (SDU) at Yale New Haven Hospital. During the COVID-19 pandemic, many tracheostomized patients stayed in the hospital for prolonged ventilator weaning and decannulation. The authors hypothesized that a staffing model with a small, consistent group of physicians and advanced practice providers (APPs) might reduce barriers to weaning by increasing staff familiarity with protocols and building stronger relationships with patients and families.<br /><br />Researchers retrospectively reviewed data from April 2020 to May 2022 for 185 patients admitted to the SDU. A new staffing model began in February 2021, in which the same small team of MDs and APPs continuously rotated through the unit. Ventilator weaning protocols were used both before and after this change.<br /><br />Overall, 46% of patients (86 total) were successfully weaned from mechanical ventilation. Of those who weaned, 26% occurred before the staffing change (22 patients) and 74% occurred after it began (64 patients). The average number of patients weaned per month increased from 2.2 before the staffing model to 4.79 after implementation. This improvement was statistically significant (p = 0.01).<br /><br />The authors conclude that enhanced staffing continuity was associated with better ventilator weaning outcomes. They suggest that the smaller rotating team became more proficient with unit protocols and more comfortable managing weaning decisions. Continuity also appeared to strengthen trust with families, helping with goals-of-care discussions when needed.<br /><br />A key limitation was the relatively small sample size. The authors recommend further studies in other SDUs or intensive care units to better understand the impact of provider continuity on mechanical ventilation weaning.

Asset Subtitle

Heather L. Carney

Meta Tag

Author List Astha Chichra, Heather L. Carney, Nicole Schneider, Robert L. Fogerty, Tooba Kazmi

Category Research

Concept Provider Continuity

Concept Mechanical Ventilator Weaning

Concept Weaning Rate

Concept Staffing Model

Concept Retrospective Study

Distinguished Non-Finalist

Presenter Organization Yale-New Haven Hospital

Presenting Author Heather L. Carney

Track Outcomes Research

Keywords

provider continuity

ventilator weaning

inpatient pulmonary stepdown unit

tracheostomy

mechanical ventilation

staffing model

advanced practice providers

COVID-19 pandemic

weaning protocols

Yale New Haven Hospital

Provider Continuity

Mechanical Ventilator Weaning

Weaning Rate

Staffing Model

Retrospective Study