Development of Adult Multidisciplinary Tracheostomy Rounding Teams: Prevalence, Template for Starting, and Analysis for Diffusion of Innovation

Educational Objective: At the conclusion of this presentation, the participants should be able to (a) Describe the prevalence of adult tracheostomy teams in the Middle Section; (b) Outline the impact of dedicated tracheostomy rounding teams; (c) Craft strategies for multidisciplinary rounding team including the necessary personnel; (d) Identify accelerants and barriers to incorporation of the team at their institution or community. Objectives: Multidisciplinary tracheostomy rounding teams have been found to decrease days to speech and decannulation and decrease adverse events. The need of such teams and the characteristics that increase or inhibit the tracheostomy rounding team's implementation rates have not been well described. This quality improvement study and intervention aimed to (a) characterize the prevalence of inpatient teams dedicated to adult tracheostomy patients in the Middle Section; (b) describe strategies to develop a dedicated tracheostomy rounding team; (c) discuss plans to optimize Diffusion of the innovation based on Rodgers’ 1962 text that will increase adoption at other Middle Section institutions. Study Design: This prospective and retrospective quality improvement study both quantitatively and qualitatively analyzed the need, development, and implementation of a multidisciplinary tracheostomy rounding team at two Middle Section institutions. Methods: Inquiries were sent to academic departments throughout the programs in the Middle Section of the Triological Society regarding the presence of a dedicated adult team. Two institutions simultaneously formed tracheostomy teams with different strategies. Results: Only one of the academic departments that responded had a dedicated tracheostomy rounding team for adults. Analyzing the process of our tracheostomy team development, we share strategies to enhance the diffusion process, while recognizing that the time constraints and compensation of the stakeholders involved could be barriers moving forward. Conclusion: Overall, despite literature demonstrating that tracheostomy rounding teams lead to improved patient care and better navigation of the healthcare system by patients and their families, this type of multidisciplinary intervention is underutilized at many programs. Characterizing the development of a tracheostomy rounding team and creating a collaborative network for feedback and implementation help is necessary for its continued momentum and effectiveness.