Implementing the Global Tracheostomy Collaborative (GTC) quality improvement project

University Hospital of South Manchester

  • ​Led by the University Hospital of South Manchester, in partnership with East Cheshire NHS Trust, Tameside NHS Trust and Stockport NHS Foundation Trust.
  • Implemented in four diverse hospitals in South Manchester.
  • Aimed to reduce the frequency, nature and severity of harm associated with health care for people with tracheostomies, and reduce unplanned critical care admissions.
  • Incorporated a number of interventions, including education, clinical management, evidence-based protocols and checklists.

This project led by the University Hospital of South Manchester aimed to improve tracheostomy care by incorporating best practice initiatives from the Global Tracheostomy Collaborative (GTC) – an international quality improvement (QI) collaborative for tracheostomy care.

Tracheostomies are small plastic tubes that are inserted into the neck to act as artificial airways. Around 15,000 patients in England and Wales have new tracheostomies each year. These patients need competent, knowledgeable care to keep them safe as airway problems can rapidly become fatal, especially in the critically ill.

To look at ways to improve tracheostomy care, a number of QI measures were introduced into four hospitals in South Manchester. Resources included staff education, equipment provision, re-organisation of care, and involvement of patient and staff champions. This ensured rapid adoption of interventions that individually had been shown to improve the quality and safety of care for patients with tracheostomies around the world. The GTC database allowed the project team to track patient outcomes and key metrics for nearly 300 patients, benchmarking against historical data and global peers, and producing trend analysis.

The project resulted in significant improvements in the frequency, nature and severity of harm of tracheostomy-related patient safety incidents, as well as reductions in length of stay. The project has demonstrated that it is possible to improve quality and safety of care by introducing innovative changes to the way hospitals manage these patients.

Implementing the project across four diverse sites highlighted the variety and nature of obstacles that tracheostomy QI initiatives must overcome.

A Health Foundation-funded ‘Spreading Improvement’ project will see the Royal College of Anaesthetists taking the lead on scaling up this successful work; improving care for these high-risk patients on a national scale.

Contact details

For further information about the project, please email Dr Brendan McGrath at University Hospital of South Manchester.

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