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“Trach Me Home”: A Multidisciplinary Team Checklist to Reduce Readmissions and Emergency Department Visits Following Tracheostomy Placement in Ventilator Dependent Pediatric Patients
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A2051 - “Trach Me Home”: A Multidisciplinary Team Checklist to Reduce Readmissions and Emergency Department Visits Following Tracheostomy Placement in Ventilator Dependent Pediatric Patients
Author Block: G. F. Perez1, A. Espinel2, M. Sharron3, H. Grenlick3, M. Farrar-Simpson4, R. Shah2; 1Pulmonary, National Children's Medical Center, Washington, DC, United States, 2Otorhinolaryngology, National Children's Medical Center, Washington, DC, United States, 3Pediatric Critical Care Medicine, National Children's Medical Center, Washington, DC, United States, 4Case Management, National Children's Medical Center, Washington, DC, United States.
Objective: Tracheostomy is an essential procedure to provide stable, prolonged mechanical ventilation that allows pediatric ventilator dependent patients to live in the home environment. For the transition home to occur there is a steep learning curve for caregivers in order to provide safe home care for this patient population. The initial first weeks at home represent the highest likelihood of a readmission for tracheostomy related complications. As part of Children’s National Transformation 2018, a multidisciplinary team developed a tracheostomy care initiatives to ensure a safe and seamless discharge home and reduce tracheostomy related readmissions.
Methods: After implementation of multidisciplinary initiatives aimed at assisting the transition to the home environment, a quality initiative investigated the 30 day readmission rates for ventilator dependent tracheostomy patients. Cost savings analysis was performed to assess the costs saved in charges based on this decrease. Results: The 30 day readmission rate for tracheostomy related complications was reduced 62.4% (15.4% from 77.8%) in the first year following implementation of the multidisciplinary team and checklist for ventilator dependent tracheostomy patients. This change was sustained over the next 2 years with readmission rates sustaining at 13.3% and 15.0%. For fiscal year 2017, this equates to a cost savings of $2.8 million.
Conclusions: A multidisciplinary team approach utilizing a checklist outlining all the essential steps from tracheostomy placement until discharge reduces readmission rates in tracheostomy ventilator dependent patients.
Author Block: G. F. Perez1, A. Espinel2, M. Sharron3, H. Grenlick3, M. Farrar-Simpson4, R. Shah2; 1Pulmonary, National Children's Medical Center, Washington, DC, United States, 2Otorhinolaryngology, National Children's Medical Center, Washington, DC, United States, 3Pediatric Critical Care Medicine, National Children's Medical Center, Washington, DC, United States, 4Case Management, National Children's Medical Center, Washington, DC, United States.
Objective: Tracheostomy is an essential procedure to provide stable, prolonged mechanical ventilation that allows pediatric ventilator dependent patients to live in the home environment. For the transition home to occur there is a steep learning curve for caregivers in order to provide safe home care for this patient population. The initial first weeks at home represent the highest likelihood of a readmission for tracheostomy related complications. As part of Children’s National Transformation 2018, a multidisciplinary team developed a tracheostomy care initiatives to ensure a safe and seamless discharge home and reduce tracheostomy related readmissions.
Methods: After implementation of multidisciplinary initiatives aimed at assisting the transition to the home environment, a quality initiative investigated the 30 day readmission rates for ventilator dependent tracheostomy patients. Cost savings analysis was performed to assess the costs saved in charges based on this decrease. Results: The 30 day readmission rate for tracheostomy related complications was reduced 62.4% (15.4% from 77.8%) in the first year following implementation of the multidisciplinary team and checklist for ventilator dependent tracheostomy patients. This change was sustained over the next 2 years with readmission rates sustaining at 13.3% and 15.0%. For fiscal year 2017, this equates to a cost savings of $2.8 million.
Conclusions: A multidisciplinary team approach utilizing a checklist outlining all the essential steps from tracheostomy placement until discharge reduces readmission rates in tracheostomy ventilator dependent patients.
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