ABSTRACT
Introduction: At the height of the COVID-19 pandemic, our institution instituted a safe tracheostomy aftercare taskforce (STAT) team to care for the influx of patients undergoing tracheostomies. This review was undertaken to quantify and understand this team's benefits on the outcomes of tracheostomy care. Method: Retrospective data were collected from patients undergoing tracheostomies at our institution from February to June 2019, prior to creation of the STAT team, and was compared with prospectively collected data from tracheostomies performed from February to June 2020 while the STAT team was in place. The primary endpoint was decannulation before discharge. Secondary endpoints included downsizing and outpatient follow-up. Results: Prior to the STAT team, 92 patients underwent tracheostomy from February to June 2019, including 59 males (64%) and 33 females (36%). Following implementation of the STAT team, 170 patients underwent tracheostomy from February to June 2020, including 106 males (62%) and 64 females (38%). Mean time from tracheostomy to discharge was 43.7 days (range, 1-174;standard deviation [SD] 45.5) in 2019 and 39.7 days (range, 2-205;SD 30.3) in 2020. Twenty (22%) and 26 patients (15%) expired in the 2019 and 2020 cohorts, respectively. Of the surviving patients, 22% of patients in 2019 compared with 60% of patients in 2020 were decannulated before discharge (P < .00001). With the STAT team, decannulation rates before discharge increased absolutely by 40% and relatively by 178%. In the 2020 cohort, 59% of patients had documented downsizes during admission compared with just 20% of patients in 2019 (P < .0001). In 2020 the STAT team remained in contact to advise further tracheostomy care for 86% of discharged patients. Conclusion: The STAT team significantly increased decannulation rates, documentation of downsizing, and improved follow-up for tracheostomy care. It is possible that the STAT team's positive impact was related to improved documentation of significant tracheostomy care events. Nevertheless, this type of care team provides significant benefit to hospitals and improves the overall care of patients with tracheostomies.