Joe DiMaggio Children's Hospital Logo

In January 2014, Diane Randall, RT-NPS, in conjunction with her health care colleagues, Dr. Samuel Ostrower, and Saundra Santaro, began to develop a program to improve the quality of care for patients with tracheostomies at Joe DiMaggio Children’s Hospital.  Like many hospitals, multi-disciplinary trach care teams did not exist, nor were there established educational guidelines for patient/patient families, and hospital staff members.

Diane took this gigantic task to heart…. she researched books, web pages, instructional materials and educational videos.  After careful review of available materials, she used multiple sources to create an individualized tracheostomy care “sequence” that would go into immediate implementation when a new patient is identified who is going to require a tracheotomy. (Please see the documents attached below for more detail).

With great insight, she and her colleagues agreed that tracheostomy education should begin BEFORE the tracheotomy is performed.   As soon as a patient is identified who will require a tracheotomy, the doctor (Dr. Ostrower) obtains informed consent, and has the first educational discussion.  The patient/family are then immediately assigned primary and secondary respiratory therapists as “trainers” who start educating the patient and their family before the procedure is ever done:  (1.) an educational binder with detailed information (2.) educational videos  and (3.) hands on training with a trach “doll.”  The patient and family are then sequentially taken through the entire process— from the actual tracheotomy to the final discharge— even following up with the family after discharge home (see Tracheostomy and Ventilator Training Proposal for details).

As a future goal, additional health care providers to be members of the multi-disciplinary trach team will be trained and required to meet clearly defined educational standards before assuming their roles.   The Global Tracheostomy Collaborative is thrilled to see the phenomenal progress that Diane, Dr. Ostrower, and their colleagues have made at their hospital, and we’re honored to have them as part of our international collaborative!