Abstract Introduction Patients with tracheostomies and ventilator dependence require coordinated multidisciplinary care to optimize outcomes and minimize complications. The American Thoracic Society recommends that patients with tracheostomies be evaluated by Otolaryngology (ENT) every 6-12 months. Review of charts from our tracheostomy/ventilator (trach/vent) clinic revealed low rates of ENT follow-up, with only 56.5% of patients seen within 6 months. Our SMART aim was to increase scheduled ENT follow-up for trach/vent-dependent patients by 20% within four months (November 2024 - March 2025) through collaborative interventions between ENT and pulmonary teams. Methods Baseline data were collected from 204 active patients followed in the trach/vent clinic at Texas Children’s Hospital. Patients deceased, with protected charts, or following with outside ENT providers were excluded. Three sequential Plan-Do-Study-Act (PDSA) cycles were implemented to address gaps in care coordination. In PDSA Cycle 1, an ENT coordinator joined trach/vent clinic huddles to identify patients due for follow-up and facilitate scheduling. In PDSA Cycle 2, the clinic coordinator sent MyChart blast reminders to families encouraging them to schedule ENT appointments. In PDSA Cycle 3, a standardized reminder was added to the trach/vent after-visit summary (AVS) to reinforce ENT follow-up. The primary outcome was the percentage of patients with scheduled ENT follow-up within six months. Process measures included the percentage of ENT appointments made, and balancing measures tracked parental calls, family burden, and staff workload. Results At baseline, 56.5% of patients had ENT follow-up within six months. After PDSA Cycle 1, 23 additional patients scheduled visits, representing a 12.8% increase. Following PDSA Cycle 2, 18 more patients scheduled visits, for a 22.6% increase from baseline. After PDSA Cycle 3, an additional three patients scheduled follow-up, achieving a total 24.4% increase from baseline. Balancing measures showed a small rise in parental calls and staff workload, mitigated through improved documentation and communication between coordinators and providers. See Figure 1 for result summary. Conclusions Through multidisciplinary collaboration and systematic reminders, our team successfully increased scheduled ENT follow-up for trach/vent-dependent patients by 24.4% over four months, surpassing the 20% improvement target. This project demonstrates the effectiveness of shared communication, electronic reminders, and standardized documentation in enhancing continuity of care for medically complex pediatric patients. Sustaining these interventions and exploring automated scheduling integration are planned next steps. This abstract is funded by: None
Gomez et al. (Fri,) studied this question.