Journal ArticleDOI
Global Tracheostomy Collaborative: data-driven improvements in patient safety through multidisciplinary teamwork, standardisation, education, and patient partnership
Michael Brenner,Vinciya Pandian,Carly E. Milliren,Dionne A. Graham,Charissa J. Zaga,Linda L. Morris,Joshua R. Bedwell,Preety Das,Hannah Zhu,John Lee Y. Allen,John Lee Y. Allen,Alon Peltz,Kimberly Chin,Bradley A. Schiff,Diane Randall,Chloe Swords,Darrin French,Erin Ward,Joanne M. Sweeney,Stephen J Warrillow,Asit Arora,Anthony Narula,Brendan McGrath,Tanis S. Cameron,David W. Roberson +24 more
TLDR
The history of the collaborative, its database infrastructure and analytics, and patient outcomes from more than 6500 patients globally are reported, providing the foundation for future risk-adjusted benchmarking and a learning community that drives ongoing quality improvement efforts worldwide.Abstract:
Summary There is growing recognition of the need for a coordinated, systematic approach to caring for patients with a tracheostomy. Tracheostomy-related adverse events remain a pervasive global problem, accounting for half of all airway-related deaths and hypoxic brain damage in critical care units. The Global Tracheostomy Collaborative (GTC) was formed in 2012 to improve patient safety and quality of care, emphasising knowledge, skills, teamwork, and patient-centred approaches. Inspired by quality improvement leads in Australia, the UK, and the USA, the GTC implements and disseminates best practices across hospitals and healthcare trusts. Its database collects patient-level information on quality, safety, and organisational efficiencies. The GTC provides an organising structure for quality improvement efforts, promoting safety of paediatric and adult patients. Successful implementation requires instituting key drivers for change that include effective training for health professionals; multidisciplinary team collaboration; engagement and involvement of patients, their families, and carers; and data collection that allows tracking of outcomes. We report the history of the collaborative, its database infrastructure and analytics, and patient outcomes from more than 6500 patients globally. We characterise this patient population for the first time at such scale, reporting predictors of adverse events, mortality, and length of stay indexed to patient characteristics, co-morbidities, risk factors, and context. In one example, the database allowed identification of a previously unrecognised association between bleeding and mortality, reflecting ability to uncover latent risks and promote safety. The GTC provides the foundation for future risk-adjusted benchmarking and a learning community that drives ongoing quality improvement efforts worldwide.read more
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Journal ArticleDOI
Tracheostomy During the COVID-19 Pandemic: Comparison of International Perioperative Care Protocols and Practices in 26 Countries.
Carol M. Bier-Laning,John D. Cramer,Soham Roy,Patrick A. Palmieri,Ayman Amin,J.M. Añón,Cesar Antonio Bonilla-Asalde,Patrick J. Bradley,Pankaj Chaturvedi,David Cognetti,Fernando Luiz Dias,Arianna Di Stadio,Johannes J. Fagan,David Feller-Kopman,Sheng Po Hao,Sheng Po Hao,Kwang Hyun Kim,Petri Koivunen,Woei Shyang Loh,Jobran Mansour,Matthew R. Naunheim,Marcus J. Schultz,Marcus J. Schultz,Marcus J. Schultz,You Shang,Davud Sirjani,Maie A. St. John,Maie A. St. John,Joshua K. Tay,Sébastien Vergez,Heather M. Weinreich,Eddy W.Y. Wong,Johannes Zenk,Christopher H. Rassekh,Michael Brenner +34 more
TL;DR: Wide variation exists in tracheostomy protocols, reflecting geographical variation, different resource constraints, and limited data to drive evidence-based care standards.
Journal ArticleDOI
Speech-Language Pathology Guidance for Tracheostomy During the COVID-19 Pandemic: An International Multidisciplinary Perspective.
Charissa J. Zaga,Vinciya Pandian,Martin B. Brodsky,Sarah Wallace,Tanis S. Cameron,Caroline Chao,Lisa A. Orloff,Naomi E. Atkins,Brendan McGrath,Cathy L. Lazarus,Adam P. Vogel,Michael Brenner +11 more
TL;DR: This tutorial provides guidance on practices for safely performing patient evaluation and procedures, thereby reducing risk of infection in speech-language pathologists caring for patients with tracheostomy and known or suspected COVID-19 infection.
Journal ArticleDOI
Multidisciplinary Safety Recommendations After Tracheostomy During COVID-19 Pandemic: State of the Art Review.
Kara D. Meister,Vinciya Pandian,Alexander T. Hillel,Brian K Walsh,Martin B. Brodsky,Karthik Balakrishnan,Simon R. Best,Steven B. Chinn,John D. Cramer,Evan M. Graboyes,Brendan McGrath,Christopher H. Rassekh,Joshua R. Bedwell,Joshua R. Bedwell,Michael Brenner +14 more
TL;DR: This review addresses gaps in the literature regarding posttracheostomy care, outlining modifications to conventional algorithms, raising vigilance for heightened risks of bleeding or other complications, and offering recommendations for personal protective equipment, equipment, care protocols, and personnel.
Journal ArticleDOI
Association of Early vs Late Tracheostomy Placement With Pneumonia and Ventilator Days in Critically Ill Patients: A Meta-analysis.
TL;DR: Early tracheotomy was associated with lower VAP rates and shorter durations of mechanical ventilation and ICU stay, but not with reduced short-term, all-cause mortality.
Journal ArticleDOI
Timing of Tracheostomy for Patients With COVID-19 in the ICU-Setting Precedent in Unprecedented Times.
TL;DR: Information actualizada sobre el nuevo coronavirus 2019, evaluación actual del riesgo, preguntas más frecuentes, publicaciones, noticias, mapas, estadísticas, informes, folletos, enlaces de interés, etc
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