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A pilot study on the provision of tracheostomy healthcare and patient engagement in quality improvement measures: a global perspective

  • C Swords (a1) (a2), A Manji (a3), E Ward (a2) and A Arora (a2) (a4)
Abstract
Background

Work describing patient and family outcomes after tracheostomy has indicated that patients do not feel prepared at the time of discharge.

Objectives

To assess healthcare professional–patient interactions in tracheostomy care and the current provision of care.

Method

A global electronic survey was disseminated via e-mail.

Results

The majority of respondents were nursing or speech and language staff, from over 10 countries. Only 23 per cent of respondents’ institutions routinely offered patients the ability to meet people with a tracheostomy pre-operatively. Only 31 per cent consistently provided or co-ordinated full nursing and equipment requirements on discharge. Only half of the institutions participated in tracheostomy quality improvement initiatives; less than one-third of these involved patients.

Conclusion

The provision of tracheostomy care in hospital and at discharge can be improved. The current practice of clinician-led audit is becoming less viable; future initiatives should focus upon patient-centred outcomes to ensure excellence in healthcare delivery.

Copyright
Corresponding author
Author for correspondence: Miss Chloe Swords, Department of Otolaryngology, North West Anglia NHS Foundation Trust, Peterborough, UK E-mail: chloeswords@doctors.org.uk
Footnotes
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Miss C Swords takes responsibility for the integrity of the content of the paper

Footnotes
References
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1McGrath, BA, Lynch, J, Bonvento, B, Wallace, S, Poole, V, Farrell, A et al. Evaluating the quality improvement impact of the Global Tracheostomy Collaborative in four diverse NHS hospitals. BMJ Qual Improv Rep 2017;6
2McCormick, ME, Ward, E, Roberson, DW, Shah, RK, Stachler, RJ, Brenner, MJ. Life after tracheostomy. Otolaryngol Neck Surg 2015;153:914–20
3Arora, A, Hettige, R, Ifeacho, S, Narula, A. Driving standards in tracheostomy care: a preliminary communication of the St Mary's ENT-led multi disciplinary team approach. Clin Otolaryngol 2008;33:596–9
4Mitchell, RB, Hussey, HM, Setzen, G, Jacobs, IN, Nussenbaum, B, Dawson, C et al. Clinical consensus statement: tracheostomy care. Otolaryngol Head Neck Surg 2013;148:620
5Loerzel, VW, Crosby, WW, Reising, E, Sole, ML. Developing the Tracheostomy Care Anxiety Relief Through Education and Support (T-CARES) Program. Clin J Oncol Nurs 2014;18:522–7
6Robert, G, Cornwell, J, Locock, L, Purushotham, A, Sturmey, G, Gager, M. Patients and staff as codesigners of healthcare services. BMJ 2015;350:g7714
7Lord, L, Gale, N. Subjective experience or objective process: understanding the gap between values and practice for involving patients in designing patient-centred care. J Health Organ Manag 2014;28:714–30
8Streiner, D, Norman, G, Cairney, J. Health Measurement Scales: A Practical Guide to Their Development and Use, 5th edn. Oxford: Oxford University Press, 2016;294–5
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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