Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 3588-3601 |
| Number of pages | 14 |
| Journal | Laryngoscope |
| Volume | 133 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 2023 |
Funding
Dr. Yang is a scholar in the Einstein Clinical Research Training Program (supported by NIH/National Center for Advancing Translational Science (NCATS) Einstein Montefiore CTSA Grant Number UL1TR001073). We acknowledge all authors who contributed to this manuscript, including members of the Pediatric Tracheostomy Emergency Readiness Workgroup: Evan J. Propst, MD2 Karthik Balakrishnan, MD, MPH, FAAP, FACS3 Michael J. Brenner, MD6 Christina J. Yang, MD1,5 Jeffrey P. Simons, MD, MMM7 Eric Moreddu, MD, PhD8 Briac Thierry, MD9 Eric Gantwerker, MD, M.M.Sc. (MedEd), FACS10 David R. White, MD11 Paul Hong, MD, MSc12 Margo K. McKenna, MD13 David W. Molter, MD14 Marlene Soma, MBBS, FRACS15 Mike J. Rutter, FRACS16 Neha A. Patel, MD10 Stephen R. Chorney, MD, MPH17 Liane B. Johnson, MDCM, FRCSC, FACS12 John D. Prosser, MD18 Douglas R. Sidell, MD, FAAP, FACS3 Gresham T. Richter, MD19 Brandon S. Hopkins, MD20 Marc Gibber, MD1,5 Clarice Clemmens, MD21 Soham Roy, MD, MMM22 Derek J. Lam, MD, MPH23 Sukgi Choi, MD, MBA24 Jason May, MD25 Matthew T. Brigger, MD, MPH26 Craig S. Derkay, MD27 Wei-Chung Hsu, MD, Ph.D28 Scott Schraff, MD29 Johnathan D. McGinn, MD, FACS30 Jonathan B. Ida, MD, MBA31 Michel Nassar, MD, MSc1,5 Joshua R. Bedwell, MD, MS32 Reza Rahbar, MD24 Michele Torre, MD33 Scott E. Mann, MD34 David A. Zopf, MD, MS6 Robert Chun, MD35 Erynne A. Faucett, MD36 Maja Svrakic, MD, MSEd37 Sam J. Daniel, MD38 Mathieu Bergeron, BPharm, MD, FRCSC39 Seth M Pransky, MD40 Lyndy J. Wilcox, MD41 Nira A. Dr. Yang is a scholar in the Einstein Clinical Research Training Program (supported by NIH/National Center for Advancing Translational Science (NCATS) Einstein Montefiore CTSA Grant Number UL1TR001073). We acknowledge all authors who contributed to this manuscript, including members of the Pediatric Tracheostomy Emergency Readiness Workgroup:
Keywords
- Delphi Technique
- airway management
- healthcare quality assessments
- patient safety
- simulation
- tracheostomy
ASJC Scopus subject areas
- Otorhinolaryngology