Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations

Objective: To achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems factors along with tracheostomy-specific steps.

Methods: A modified Delphi method was used. Using REDCap software, an instrument comprising 29 potential items was circulated to 171 tracheostomy and simulation experts. Consensus criteria were determined a priori with a goal of consolidating and ordering 15 to 25 final items. In the first round, items were rated as “keep” or “remove”. In the second and third rounds, experts were asked to rate the importance of each item on a 9-point Likert scale. Items were refined in subsequent iterations based on analysis of results and respondents' comments.

Results: The response rates were 125/171 (73.1%) for the first round, 111/125 (88.8%) for the second round, and 109/125 (87.2%) for the third round. 133 comments were incorporated. Consensus (>60% participants scoring ≥8, or mean score >7.5) was reached on 22 items distributed across three domains. There were 12, 4, and 6 items in the domains of tracheostomy-specific steps, team and personnel factors, and equipment respectively.

Conclusions: The resultant assessment tool can be used to assess both tracheostomy-specific steps as well as systems factors affecting hospital team response to simulated and clinical pediatric tracheostomy emergencies. The tool can also be used to guide debriefing discussions of both simulated and clinical emergencies, and to spur quality improvement initiatives.

Level of Evidence: 5 Laryngoscope, 133:3588–3601, 2023.

This is the peer reviewed version of the following article: [Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations. The Laryngoscope 133, 12 p3588-3601 (2023)], which has been published in final form at https://doi.org/10.1002/lary.30674. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions: https://authorservices.wiley.com/author-resources/Journal-Authors/licensing/self-archiving.html#3.

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Work Title Pediatric Tracheostomy Emergency Readiness Assessment Tool: International Consensus Recommendations
Access
Open Access
Creators
  1. Elliot Schiff
  2. Evan J. Propst
  3. Karthik Balakrishnan
  4. Kaalan Johnson
  5. David W. Lounsbury
  6. Michael J. Brenner
  7. Marc-Mina Tawfik
  8. Pediatric Tracheostomy Emergency Readiness Workgroup
  9. Christina J. Yang
Keyword
  1. Healthcare quality assessments
  2. Simulation
  3. Airway
  4. Education intervention
  5. Tracheostomy
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. The Laryngoscope
Publication Date April 28, 2023
Publisher Identifier (DOI)
  1. https://doi.org/10.1002/lary.30674
Deposited March 12, 2024

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Version 1
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  • Created
  • Added lscope-22-2662.R1_Proof_hi.pdf
  • Added Creator Elliot Schiff
  • Added Creator Evan J. Propst
  • Added Creator Karthik Balakrishnan
  • Added Creator Kaalan Johnson
  • Added Creator David W. Lounsbury
  • Added Creator Michael J. Brenner
  • Added Creator Marc Mina Tawfik
  • Added Creator Jeffrey P. Simons
  • Added Creator Eric Moreddu
  • Added Creator Briac Thierry
  • Added Creator Eric Gantwerker
  • Added Creator David R. White
  • Added Creator Paul Hong
  • Added Creator Margo K. McKenna
  • Added Creator David W. Molter
  • Added Creator Marlene Soma
  • Added Creator Mike J. Rutter
  • Added Creator Neha A. Patel
  • Added Creator Stephen R. Chorney
  • Added Creator Liane B. Johnson
  • Added Creator John D. Prosser
  • Added Creator Douglas R. Sidell
  • Added Creator Gresham T. Richter
  • Added Creator Brandon S. Hopkins
  • Added Creator Marc Gibber
  • Added Creator Clarice Clemmens
  • Added Creator Soham Roy
  • Added Creator Derek J. Lam
  • Added Creator Sukgi Choi
  • Added Creator Jason May
  • Added Creator Matthew T. Brigger
  • Added Creator Craig S. Derkay
  • Added Creator Wei Chung Hsu
  • Added Creator Scott Schraff
  • Added Creator Johnathan D. McGinn
  • Added Creator Jonathan B. Ida
  • Added Creator Michel Nassar
  • Added Creator Joshua R. Bedwell
  • Added Creator Reza Rahbar
  • Added Creator Michele Torre
  • Added Creator Scott E. Mann
  • Added Creator David A. Zopf
  • Added Creator Robert Chun
  • Added Creator Erynne A. Faucett
  • Added Creator Maja Svrakic
  • Added Creator Sam J. Daniel
  • Added Creator Mathieu Bergeron
  • Added Creator Seth M. Pransky
  • Added Creator Lyndy J. Wilcox
  • Added Creator Nira A. Goldstein
  • Published
  • Updated Keyword, Publisher, Description, and 1 more Show Changes
    Keyword
    • Healthcare quality assessments, Simulation, Airway, Education intervention, Tracheostomy
    Publisher
    • Laryngoscope
    • The Laryngoscope
    Description
    • <p>Objective: To achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems factors along with tracheostomy-specific steps. Methods: A modified Delphi method was used. Using REDCap software, an instrument comprising 29 potential items was circulated to 171 tracheostomy and simulation experts. Consensus criteria were determined a priori with a goal of consolidating and ordering 15 to 25 final items. In the first round, items were rated as “keep” or “remove”. In the second and third rounds, experts were asked to rate the importance of each item on a 9-point Likert scale. Items were refined in subsequent iterations based on analysis of results and respondents' comments. Results: The response rates were 125/171 (73.1%) for the first round, 111/125 (88.8%) for the second round, and 109/125 (87.2%) for the third round. 133 comments were incorporated. Consensus (&gt;60% participants scoring ≥8, or mean score &gt;7.5) was reached on 22 items distributed across three domains. There were 12, 4, and 6 items in the domains of tracheostomy-specific steps, team and personnel factors, and equipment respectively. Conclusions: The resultant assessment tool can be used to assess both tracheostomy-specific steps as well as systems factors affecting hospital team response to simulated and clinical pediatric tracheostomy emergencies. The tool can also be used to guide debriefing discussions of both simulated and clinical emergencies, and to spur quality improvement initiatives. Level of Evidence: 5 Laryngoscope, 133:3588–3601, 2023.</p>
    • <p>Objective: To achieve consensus on critical steps and create an assessment tool for actual and simulated pediatric tracheostomy emergencies that incorporates human and systems factors along with tracheostomy-specific steps.
    • Methods: A modified Delphi method was used. Using REDCap software, an instrument comprising 29 potential items was circulated to 171 tracheostomy and simulation experts. Consensus criteria were determined a priori with a goal of consolidating and ordering 15 to 25 final items. In the first round, items were rated as “keep” or “remove”. In the second and third rounds, experts were asked to rate the importance of each item on a 9-point Likert scale. Items were refined in subsequent iterations based on analysis of results and respondents' comments.
    • Results: The response rates were 125/171 (73.1%) for the first round, 111/125 (88.8%) for the second round, and 109/125 (87.2%) for the third round. 133 comments were incorporated. Consensus (&gt;60% participants scoring ≥8, or mean score &gt;7.5) was reached on 22 items distributed across three domains. There were 12, 4, and 6 items in the domains of tracheostomy-specific steps, team and personnel factors, and equipment respectively.
    • Conclusions: The resultant assessment tool can be used to assess both tracheostomy-specific steps as well as systems factors affecting hospital team response to simulated and clinical pediatric tracheostomy emergencies. The tool can also be used to guide debriefing discussions of both simulated and clinical emergencies, and to spur quality improvement initiatives.
    • Level of Evidence: 5 Laryngoscope, 133:3588–3601, 2023.</p>
    Publication Date
    • 2023-12-01
    • 2023-04-28
  • Deleted Creator Jeffrey P. Simons
  • Deleted Creator Eric Moreddu
  • Deleted Creator Briac Thierry
  • Deleted Creator Eric Gantwerker
  • Deleted Creator David R. White
  • Deleted Creator Paul Hong
  • Deleted Creator Margo K. McKenna
  • Deleted Creator David W. Molter
  • Deleted Creator Marlene Soma
  • Deleted Creator Mike J. Rutter
  • Deleted Creator Neha A. Patel
  • Deleted Creator Stephen R. Chorney
  • Deleted Creator Liane B. Johnson
  • Deleted Creator John D. Prosser
  • Deleted Creator Douglas R. Sidell
  • Deleted Creator Gresham T. Richter
  • Deleted Creator Brandon S. Hopkins
  • Deleted Creator Marc Gibber
  • Deleted Creator Clarice Clemmens
  • Deleted Creator Soham Roy
  • Deleted Creator Derek J. Lam
  • Deleted Creator Sukgi Choi
  • Deleted Creator Jason May
  • Deleted Creator Matthew T. Brigger
  • Deleted Creator Craig S. Derkay
  • Deleted Creator Wei Chung Hsu
  • Deleted Creator Scott Schraff
  • Deleted Creator Johnathan D. McGinn
  • Deleted Creator Jonathan B. Ida
  • Deleted Creator Michel Nassar
  • Deleted Creator Joshua R. Bedwell
  • Deleted Creator Reza Rahbar
  • Deleted Creator Michele Torre
  • Deleted Creator Scott E. Mann
  • Deleted Creator David A. Zopf
  • Deleted Creator Robert Chun
  • Deleted Creator Erynne A. Faucett
  • Deleted Creator Maja Svrakic
  • Deleted Creator Sam J. Daniel
  • Deleted Creator Mathieu Bergeron
  • Deleted Creator Seth M. Pransky
  • Deleted Creator Lyndy J. Wilcox
  • Renamed Creator Marc-Mina Tawfik Show Changes
    • Marc Mina Tawfik
    • Marc-Mina Tawfik
  • Renamed Creator Pediatric Tracheostomy Emergency Readiness Workgroup Show Changes
    • Nira A. Goldstein
    • Pediatric Tracheostomy Emergency Readiness Workgroup
  • Added Creator Christina J. Yang
  • Updated