AI Article Synopsis
- - Objective was to assess how a "Tracheostomy Team" affects survival rates and hospital stay length in a level IV NICU setting.
- - After implementing a multidisciplinary approach through structured cycles, in-hospital survival for tracheostomy patients increased from 67% to 100%, while median length of stay remained stable overall.
- - The study highlighted that while survival improved, there was a significant rise in hospital stay specifically for patients with bronchopulmonary dysplasia (BPD), emphasizing the need to focus on preventing post-operative infections in future quality improvement initiatives.
Article Abstract
Objective: Evaluate feasibility and impact of "Tracheostomy Team" on survival and length of stay (LOS) at a level IV NICU.
Methods: Plan-do-study-act cycles targeted five Global Tracheostomy Collaborative "key drivers". From January 2017 to December 2022 multidisciplinary, bimonthly bedside rounds were conducted.
Results: After 3 cycles, in-hospital survival among 39 patients with tracheostomy improved and sustained from 67% to 100% (baseline 18/27; 66.7%; QI 35/39, 89.7%; p = 0.03). Median LOS (days [IQR]) did not significantly differ between baseline and QI (237 [57-308] vs. 217 [130-311]; p = 0.9). Among patients with BPD, median LOS was higher after QI interventions (baseline 248 [222-308] vs. QI 332.5 [283.5-392]; p = .02). Special cause variation resulted from peak increase in LOS during the COVID19 pandemic (2021). Tracheitis/pneumonia was treated significantly more frequently in QI BPD patients.
Conclusion: Multidisciplinary approach is feasible, resulting in improved survival without a sustained increase in LOS. Future QI efforts should address post-operative infectious complications.
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| http://dx.doi.org/10.1038/s41372-024-02034-x | DOI Listing |
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