Patient and caregiver experiences at a Multidisciplinary Tracheostomy Clinic

Syed Omar Ali; Tatiana Yeung; Mallory McKeon; Meaghan Maddock; Robert J Graham; Roger Nuss; Reza Rahbar; Karen Watters

doi:10.1016/j.ijporl.2020.110250

Patient and caregiver experiences at a Multidisciplinary Tracheostomy Clinic

Int J Pediatr Otorhinolaryngol. 2020 Oct:137:110250. doi: 10.1016/j.ijporl.2020.110250. Epub 2020 Jul 11.

Authors

Syed Omar Ali¹, Tatiana Yeung¹, Mallory McKeon¹, Meaghan Maddock¹, Robert J Graham², Roger Nuss³, Reza Rahbar³, Karen Watters⁴

Affiliations

¹ Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02130, USA.
² Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Longwood Avenue, Boston, 02130, Massachusetts, USA.
³ Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02130, USA; Department of Otolaryngology and Head and Neck Surgery, Harvard Medical School, Longwood Avenue, Boston, MA, 02130, USA.
⁴ Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02130, USA; Department of Otolaryngology and Head and Neck Surgery, Harvard Medical School, Longwood Avenue, Boston, MA, 02130, USA. Electronic address: karen.watters@childrens.harvard.edu.

PMID: 32896358
DOI: 10.1016/j.ijporl.2020.110250

Abstract

Introduction: Children with tracheostomy are a heterogeneous population requiring care from multiple specialties. Multidisciplinary approaches to treating such patients helps to improve the quality of care they receive. Our institution established a Multidisciplinary Tracheostomy Clinics (MDTC) to address outpatient care coordination for tracheostomy patients by providing care from multiple disciplines at a single visit. We report patient/caregivers' experiences of our MDTC.

Methods: Patients with tracheostomy or their caregivers were prospectively recruited between Dec 2017-Oct 2019 to complete surveys assessing their experience at the MDTC. Demographic and satisfaction questionnaires were sent electronically by a REDCap survey distribution tool. Demographic data were collected, such as patient's residence and education level. Medical care variables assessed included history of MDTC attendance, commute time, medical specialties seen, tracheostomy "Go-Bag" use, home-care nursing, and MDTC satisfaction ratings.

Results: Twenty-nine patients/caregivers completed the satisfaction survey and 22 completed both the satisfaction survey and demographics questionnaire. Patient ages ranged from 11 months to 36 years. Twenty-three (79%) participants commuted for up to 2 h to the MDTC, and 6 (21%) commuted for more than 2 h. The median number of medical specialties seen at the MDTC was 3. All participants were satisfied that they saw all requested specialties. Tracheostomy supplies were checked for 25 of 28 patients. Twenty-three of 28 subjects rated staff teamwork as "excellent." Twenty-four of 28 patients were "highly likely" to recommend the MDTC. Twenty-three of 28 participants were "highly likely" to return, and 4 were "somewhat likely" to return.

Conclusion: This study demonstrates that patients with tracheostomy and caregivers were satisfied with the improved coordination and facilitation of care through a Multidisciplinary Tracheostomy Clinic.

Keywords: Multidisciplinary clinic; Pediatric; Quality improvement; Tracheostomy.

MeSH terms

Adolescent
Adult
Aftercare / methods
Aftercare / organization & administration*
Ambulatory Care / methods
Ambulatory Care / organization & administration*
Ambulatory Care Facilities / organization & administration*
Caregivers / psychology*
Child
Child, Preschool
Female
Health Care Surveys
Health Services Accessibility / organization & administration
Health Services Accessibility / statistics & numerical data
Humans
Infant
Male
Patient Care Team / organization & administration*
Patient Satisfaction / statistics & numerical data*
Prospective Studies
Quality Improvement / organization & administration
Quality Improvement / statistics & numerical data
Tracheostomy*
Young Adult