Interprofessional Quality Improvement Project to Reduce the Length of Stay of Tracheostomized Patients in a Multi-Etiological Intensive Care Unit: The Contribution of Speech and Language Therapy to the Overall Result (IQ-ICU-SLT)

Reasons for long-term stays in intensive care units (ICU) include various critical conditions, prolonged weaning with post-extubation dysphagia (PED), as well as the mere presence of a tracheal cannula. In an interprofessional QM project, medicine, nursing, physiotherapy, speech and language therapy (SLT), and occupational therapy work together to reduce the length of stay (LOS) on ICU. SLT focuses on tracheal cannula management (TCM) and PED. The primary aim of SLT is the fast and safe decannulation and thereby the reduction of LOS. Two SOPs for dealing with PED patients and for structured TCM were developed for this purpose and were both implemented on a postoperative ICU, together with a SLT staff increase. To compare the effects on the intervention group (IG, n=54), a historical control (HC, n=58) group was created through a retrospective data analysis. We screened all patients from ICU (n=5,605), included those with tracheostomy and analyzed them during their ICU stay. Clinically relevant results could be demonstrated for the mean time in days of tracheostomy for those who could be decannulated (HC=43.43, IG=23.8; d=.99) and even more important LOS in days (HC=33.41, IG=23.8; d=.48). The integration of SLT in ICU care is feasible and helps to reduce LOS.