Given the potential for bias in the studies reviewed the results should be interpreted with care.ConclusionsIn the papers we appraised, patients with selleck chem Sorafenib a tracheostomy tube in situ discharged from an ICU to a general ward who received care from a dedicated multidisciplinary team as compared with standard care showed improvements in time to decannulation, length of stay and adverse events. The effects of the intervention on quality of care were not reported. These results may be applicable to the Southern Health setting; however, should be actioned with caution due to the methodological weaknesses presented in the historical control studies.Key messages? Multidisciplinary tracheostomy teams are now widespread in national and international health services and are seen to be the most appropriate model of care for tracheostomy patients.
? High-quality evidence from well-controlled studies is still needed to convincingly determine the effectiveness of a multidisciplinary team for tracheostomy patients.? All papers included in this review came to the conclusion that the introduction of multidisciplinary care reduces the average time to decannulation for tracheostomy patients discharged from the ICU to a general ward setting.? Two papers reported that multidisciplinary care reduced the overall length of stay in hospital as well as the length of stay from ICU discharge.? Generalisability of multidisciplinary teams for tracheostomy care is limited as all three teams were led by different specialists; an intensivist, an ENT specialist and a respiratory physician.
AbbreviationsENT: ear, nose and throat; ICU: intensive care unit; ITU: intensive treatment unit/intensive therapy unit; IQR: interquartile range; SCI: spinal cord injury; SpR: specialist registrar; ST2: specialist trainee year 2; TMDT: tracheostomy multidisciplinary team; TRAMS: tracheostomy review and management service.Competing interestsThe authors declare that they have no competing interests.Authors’ contributionsCG requested the systematic review from the Centre for Clinical Effectiveness and provided clinical expertise and interpretation. With assistance from CG, MG and TT developed the search strategy. MG applied inclusion criteria to search results in consultation with TT. MG appraised the three included papers. TT was a second review for all included papers.
MG prepared the first draft of this article which TT and CG then reviewed.Authors’ informationMG is a Clinical Effectiveness Project Officer at the Centre for Clinical Effectiveness, Southern Health. TT is a Clinical Effectiveness Senior Consultant at the Centre for Clinical Effectiveness, Southern Health. CG is the Manager Anacetrapib of Speech Pathology at Southern Health.Supplementary MaterialAdditional file 1: A pdf file containing the critical appraisal tables of all three included studies.Click here for file(85K, PDF)NotesSee related commentary by Yu, http://ccforum.