BackgroundInconsistent and poorly coordinated systems of tracheostomy care commonly result in frustrations, delays, and harm. Quality improvement strategies described by exemplar hospitals of the Global Tracheostomy Collaborative have potential to mitigate such problems. This three-year guided implementation program investigated interventions designed to improve quality and safety of tracheostomy care. MethodsThe program management team guided implementation of 18 interventions over three phases (baseline/implementation/evaluation). Mixed methods interviews, focus groups, and Hospital Anxiety and Depression questionnaires defined outcome measures, with patient-level databases tracking and benchmarking process metrics. Appreciative Inquiry, interviews and Normalisation Measure Development questionnaires explored change barriers and enablers. ResultsAll sites implemented at least 16/18 interventions, with the magnitude of some improvements linked to staff engagement (1536 questionnaires from 1019 staff). 2405 admissions (1868 ICU/HDU, 7.3% children) were prospectively captured. Median stay was 50 hospital days, 23 ICU days, and 28 tracheostomy days. Incident severity score reduced significantly (n=606, p<0.01). There were significant reductions in ICU (-0.25 days.month -1 ), ventilator (-0.11 days.month -1 ), tracheostomy (-0.35 days.month -1 ) and hospital (-0.78 days.month -1 ) days (all p<0.01). Time to first vocalisation and first oral intake both decreased by 7 days (n=733, p<0.01). Anxiety decreased by 44% (from 35.9% to 20.0%), and depression decreased by 55% (from 38.7% to 18.3%) (n=385, both p<0.01). Independent economic analysis demonstrated £33 251 savings per patient, with projected annual UK National Health Service savings of £275 million. ConclusionsThis guided improvement program for tracheostomy patients significantly improved the quality and safety of care, contributing rich qualitative improvement data. Patient-centred outcomes were improved along with significant efficiency and cost savings across diverse UK hospitals.

Summary Traditional methods used to disseminate educational resources to front‐line healthcare staff have several limitations. Social media may increase the visibility of these resources among targeted groups and communities. Our project aimed to disseminate key clinical messages from the National Tracheostomy Safety Project to those caring for patients with tracheostomies or laryngectomies. We commissioned an external media company to design educational material and devise a marketing strategy. We developed videos to communicate recommendations from the safety project and used Facebook, Twitter, YouTube and LinkedIn to deliver these to our target users. We recorded 629,270 impressions over a paid 12‐week campaign. Our YouTube channel registered more than a five‐fold increase in views and watch time during the campaign as compared with the previous year. Around two‐thirds of views across all platforms were from peer‐to‐peer sharing. We spent £4140 on social media advertising, with each view and click costing £0.02 and £0.67, respectively. This intelligence‐led approach using social media is an effective and efficient method to disseminate knowledge on the principles of safe tracheostomy care to front‐line clinical staff. Similar strategies may be effective for other patient safety topics, especially when targeting groups that do not use medical journals or other traditional means of dissemination.

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There is a growing concern about the transmission of bloodborne pathogens during medical procedures among health care workers and patients. Over the last three decades, radiological services have undergone many changes with the introduction of new modalities. One of these new disciplines is interventional radiology (IR) which deals with procedures such as arteriography, image-guided biopsies, intravascular catheter insertions, angioplasty and stent placements. Despite these developments, the potential for accidental blood exposure and exposure to other infectious material continues to exist. Therefore, it is important for all radiologists who perform invasive procedures to observe specific recommendations for infection control. In this review, we look at the different policies for protection and universal standards on infection control.

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