Standardizing Care and Parental Training to Improve Training Duration, Referral Frequency, and Length of Stay: Our Quality Improvement Project Experience.
OBJECTIVE
At our institution, there is a six bed Pediatric Respiratory Care Unit for technology dependent infants and children with a tracheostomy tube. A lack of consistency in patient care and parent/guardian education prompted our group to critically evaluate the services we provided by revisiting our teaching protocol and instituting a new model of care in the Unit. The aims of this quality improvement (QI) project were to standardize care and skills proficiency training to parents of infants with a tracheostomy tube in preparation for discharge to home.


METHODS
After conducting a current state survey of key unit stakeholders, we initiated a multidisciplinary, QI project to answer the question: 'could a standardized approach to care and training lead to a decrease in parental/guardian training time, a decrease in length of stay, and/or an increase in developmental interventions for infants with tracheostomy tubes'? A convenience sample of infants with a tracheostomy tube admitted to the Pediatric Respiratory Care Unit were included in the study. Descriptive statistics were used to analyze the results.


RESULTS
Through this QI approach, we were able to decrease the time required by parents to achieve proficiency in the care of a technology dependent infant, the length of stay for these infants, and increase referral of the infants for developmental assessment.


CONCLUSIONS
These outcomes have implications for how to approach deficiencies in patient care and make changes that lead to sustained improvements.
Yale University School of Medicine, Department of Pediatrics, Section of Respiratory Medicine, 333 Cedar Street, LMP 3094, New Haven, CT 06520-8064, United States. Electronic address: Tina.Tolomeo@Yale.Edu.
Concettina Tina
CT
Tolomeo
Yale University School of Medicine, Department of Pediatrics, Developmental & Behavioral Pediatrics, 1 Long Wharf Drive, 5(th) Floor, New Haven, CT 06511, United States.
Nili E
NE
Major
Yale New Haven Children's Hospital, Department of Care Coordination, 1 Park Street, New Haven, CT 06510, United States.
Mary V
MV
Szondy
Yale University School of Medicine, Department of Pediatrics, Section of Respiratory Medicine, 333 Cedar Street, LMP 3094, New Haven, CT 06520-8064, United States.
Alia
A
Bazzy-Asaad
D019091:Critical Pathways / Q000592:standards*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010290:Parents / Q000193:education*; D011368:Professional-Family Relations; D058996:Quality Improvement / Q000458:organization & administration*; D014139:Tracheostomy / Q000193:education* / Q000379:methods* / Q000451:nursing
Bronchopulmonary dysplasia; Length of stay; Multidisciplinary care; Quality improvement; Tracheostomy tube