{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:43:01Z","timestamp":1792449781068,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T00:00:00Z","timestamp":1479168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Multidisciplinary tracheostomy teams have been successful in improving operative outcomes; however, limited data exist on their effect on postoperative care. We aimed to determine the effectiveness of a multidisciplinary tracheostomy service alone and following implementation of a post-tracheostomy care bundle on rates of decannulation and tolerance of oral diet before discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Prospective data on all subjects requiring tracheostomy by any trauma\/critical care surgeon were collected from January 2011 to December 2013 following development of a tracheostomy service and continued following implementation of the post-tracheostomy care bundle. Rates of decannulation and tolerance of oral diet were compared between all groups: pre-tracheostomy service (baseline, historical control), tracheostomy service alone, and tracheostomy service with post-tracheostomy care bundle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Three hundred ninety-three subjects met the criteria for analysis with 61 in the baseline group, 124 following initiation of a tracheostomy service, and 208 after the addition of the post-tracheostomy care bundle. There were significant overall differences between all groups in the proportion of subjects decannulated, proportion of subjects tolerating oral diet, and number of subjects receiving speech evaluations. Pairwise comparisons showed no differences in decannulation or tolerance of oral diet following implementation of the tracheostomy service alone but significant improvement with the addition of the post-tracheostomy care bundle compared with baseline. (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005, respectively). Likewise, the number of speech language pathologist consults significantly increased compared with baseline only after the post-tracheostomy care bundle (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004). Time to speech evaluation significantly decreased with the post-tracheostomy care bundle compared with baseline and tracheostomy service (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .013).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The addition of a post-tracheostomy care bundle to a multidisciplinary tracheostomy service significantly improved rates of decannulation and tolerance of oral diet.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.04878","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T08:16:35Z","timestamp":1479284195000},"page":"137-143","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":54,"title":["Improving Decannulation and Swallowing Function: A Comprehensive, Multidisciplinary Approach to Post-Tracheostomy Care"],"prefix":"10.1177","volume":"62","author":[{"given":"John W","family":"Mah","sequence":"first","affiliation":[{"name":"Critical Care, Department of Surgery, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilene I","family":"Staff","sequence":"additional","affiliation":[{"name":"Department of Research, Hartford Hospital, Hartford, Connecticut."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia R","family":"Fisher","sequence":"additional","affiliation":[{"name":"Speech Therapy, Department of Rehabilitation Services, Hartford Hospital, Hartford, Connecticut."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karyn L","family":"Butler","sequence":"additional","affiliation":[{"name":"Critical Care, Department of Surgery, Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,11,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000145232.46143.40"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31824e16af"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2008.01725.x"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2011.02379.x"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2003.016956"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.043209"},{"issue":"8","key":"e_1_3_2_8_2","first-page":"A4481","article-title":"Inadequate follow-up after tracheostomy and intensive care","volume":"59","author":"Mondrup F","year":"2012","unstructured":"Mondrup F, , Skjelsager K, , Madsen KR. Inadequate follow-up after tracheostomy and intensive care. 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Social importance of dysphagia: its impact on diagnosis and therapy. 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Outcomes of patients with spinal cord injury before and after introduction of an interdisciplinary tracheostomy team. 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