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Title: Global Tracheostomy Collaborative: data-driven improvements in patient safety through multidisciplinary teamwork, standardisation, education, and patient partnership.
Austin Authors: Brenner, Michael J;Pandian, Vinciya;Graham, Dionne A;Milliren, Carly E;Zaga, Charissa J ;Morris, Linda L;Bedwell, Joshua R;Das, Preety;Zhu, Hannah;Lee Y Allen, John;Peltz, Alon;Chin, Kimberly;Schiff, Bradley A;Randall, Diane M;Swords, Chloe;French, Darrin;Ward, Erin;Sweeney, Joanne M ;Warrillow, Stephen J ;Arora, Asit;Narula, Anthony;McGrath, Brendan A;Cameron, Tanis S ;Roberson, David W
Affiliation: University of Michigan, Ann Arbor, MI, USA
Austin Health, Melbourne, VIC, Australia
Manchester University NHS Foundation Trust and University of Manchester, Manchester, UK
Johns Hopkins University, Baltimore, MD, USA
Boston Children's Hospital, Boston, MA, USA
Northwestern University Feinberg School of Medicine, Shirley Ryan Ability Lab, Chicago, IL, USA
Baylor College of Medicine, Texas Children's Center, Houston, TX, USA
Guy's and St Thomas' NHS Foundation Trust, London, UK
University of Oxford and Oxford University Hospitals NHS Foundation Trust, Oxford, UK
Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
Montefiore Medical Center, Bronx, NY, USA
Memorial Regional Health System, Fort Lauderdale, FL, USA
Addenbrooke's Hospital, Cambridge, UK
United Regional Health Care System, Wichita Falls, TX, USA
Guy's and St Thomas' NHS Foundation Trust, London, UK
Imperial Healthcare, London, UK
Bayhealth Medical Group, Milford, Global Tracheostomy Collaborative, Raleigh, NC, USA
Issue Date: Jul-2020 2020-05-23
Publication information: British journal of anaesthesia 2020; 125(1): e104-e118
Abstract: There is growing recognition of the need for a coordinated, systematic approach to caring for patients with a tracheostomy. Tracheostomy-related adverse events remain a pervasive global problem, accounting for half of all airway-related deaths and hypoxic brain damage in critical care units. The Global Tracheostomy Collaborative (GTC) was formed in 2012 to improve patient safety and quality of care, emphasising knowledge, skills, teamwork, and patient-centred approaches. Inspired by quality improvement leads in Australia, the UK, and the USA, the GTC implements and disseminates best practices across hospitals and healthcare trusts. Its database collects patient-level information on quality, safety, and organisational efficiencies. The GTC provides an organising structure for quality improvement efforts, promoting safety of paediatric and adult patients. Successful implementation requires instituting key drivers for change that include effective training for health professionals; multidisciplinary team collaboration; engagement and involvement of patients, their families, and carers; and data collection that allows tracking of outcomes. We report the history of the collaborative, its database infrastructure and analytics, and patient outcomes from more than 6500 patients globally. We characterise this patient population for the first time at such scale, reporting predictors of adverse events, mortality, and length of stay indexed to patient characteristics, co-morbidities, risk factors, and context. In one example, the database allowed identification of a previously unrecognised association between bleeding and mortality, reflecting ability to uncover latent risks and promote safety. The GTC provides the foundation for future risk-adjusted benchmarking and a learning community that drives ongoing quality improvement efforts worldwide.
DOI: 10.1016/j.bja.2020.04.054
PubMed URL: 32456776
Type: Journal Article
Subjects: adverse events
length of stay
patient safety
quality improvement
standardised care
Appears in Collections:Journal articles

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