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Last week, I introduced a study, “Addressing Education and Care Gaps in Tracheostomy Management: Insights from a Multi-Stakeholder Global Survey.” This survey was published by the Global Tracheostomy Collaborative, and last week, I talked about this really interesting and long survey. I more or less brought in the objective of the survey, the methods, the results, and also what solutions Intensive Care at Home has to offer for tracheostomy patients in the community in particular.

Today, I want to further introduce the study. It’s a long study, and I will have a multi-part series here to talk about the study. I have put a link in the written version of this blog to the study.

My name is Patrik Hutzel from intensivecareathome.com. So, let’s further talk about the study and how it was introduced. I will also link back to the first part of this series in the written version of this blog.

The increasing complexity of patient conditions and the healthcare system has led to a wider range of indications for tracheostomy. These include prolonged mechanical ventilation, upper airway obstruction, airway protection, and the need for pulmonary hygiene. Over 20 million adults globally require intensive respiratory support annually, with approximately 250,000 individuals undergoing tracheostomy primarily after invasive ventilation for critical illness. Although tracheostomies are generally beneficial in reducing sedation and enhancing patient comfort and autonomy, they also carry significant risks, including procedure-related adverse events and post-tracheostomy care complications. Adverse events such as dislodgement, occlusion, or bleeding account for a substantial proportion of airway-related deaths and hypoxic brain injuries in healthcare settings and the community, yet much of this harm is preventable. These observations highlight the need for a deeper understanding of gaps in tracheostomy care and effective prevention strategies.

Historically, emphasis has been placed on the timing, technique, and indication of tracheostomies. Despite increasing awareness of these practices, critical gaps persist in key areas such as workforce training, care partner (families and caregivers) support, and equitable access to tracheostomy care. Most tracheostomy-related adverse events stem from gaps in managing tracheostomy care rather than from the procedure itself. Understanding these issues with tracheostomy care requires a broad stakeholder engagement—a perspective that has been largely overlooked in previous studies. This gap contributes to the lack of targeted strategies and resources available to improve the safety and quality of life for tracheostomy patients.

Furthermore, tracheostomy care spans several disciplines, necessitating collaboration among physicians, nurses, respiratory therapists, physiotherapists, speech-language therapists, dieticians, and psychologists. Multi-institutional studies have demonstrated the benefits of an integrated approach to care, including reductions in mortality, adverse events, and costs, as well as quicker transitions to eating and speaking for patients, but also including going home, along with improved mental health outcomes. Further integration with care partners can help reduce gaps in airway management and tracheostomy complications, ultimately improving safety and quality of care.

The purpose of this study was to identify critical gaps in tracheostomy care, focusing on education, workforce competency, access, affordability, and caregiver empowerment, through a multi-stakeholder global survey. By exploring the perspectives of healthcare professionals, patients, and caregivers, the study aimed to provide actionable insights for implementing standardized training, enhancing care coordination, and improving equitable access to tracheostomy care globally.

Here is a participant sample. Participants from the GTC Learning Community were invited to take part in the survey through email outreach. The GTC has maintained a secure registry of patients, families, and healthcare professionals involved in its educational and quality improvement initiatives since its establishment in 2012. Membership in this learning community is cultivated through interest group forums, global webinars, international tracheostomy symposia, or referrals from patient-focused networks. Individuals who register have the option to receive newsletters, updates, and survey invitations. Survey respondents were queried about their primary identification among the listed stakeholders within the learning community, which encompassed patients, families, caregivers, social workers, hospital administrators, and a wide range of healthcare professionals.

So, takeaway point from the introduction of this survey really is that most complications from having a tracheostomy come after a tracheostomy has been done, it’s not from the procedure itself. The complications happen afterwards and obviously with Intensive Care at Home, we exclusively focused on tracheostomy care in the community. We know from experience and also from evidence that if tracheostomy patients with or without ventilation don’t have critical care nurses 24 hours a day, they are at very high risk of dying. That is evidence-based.

Not only can I give you numerous scenarios where patients have died in the community where they didn’t have critical care nurses, 24 hours a day, when they had a tracheostomy. When you look on our website at intensivecareathome.com, there’s a section called the Mechanical Home Ventilation Guidelines, which are evidence-based, and they really not only suggest but demand having 24 hour critical care nurses, 24 hours a day, in order to keep a tracheostomy patients stable at home, whether that’s adults or children.

Once again, that is actually evidence-based, something this particular survey has not said. The survey is not talking about evidence-based, which is disappointing, but we’ll come to that step by step as I go along today and over the next few videos.

So, with Intensive Care at Home, we are currently sending our ICU and critical care nurses into the home, 24 hours a day. We are providing the following:

• Home care services for ventilated adults & children with tracheostomies  with critical care nurses 24 hours a day
• Genuine alternative to a long-term stay in intensive care or at long-term acute care
• Tracheostomy care
• Home care services for patients on non-invasive ventilation such as Home BIPAP (Bilevel Positive Airway Pressure), Home CPAP (Continuous Positive Airway Pressure)
• Home TPN (Total Parenteral Nutrition), which is also known as IV nutrition
• Home IV potassium and home IV magnesium infusions, IV fluids, and IV antibiotics
• Providing central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as port management at home.
• Providing nasogastric tube  and PEG (Percutaneous Endoscopic Gastrostomy  tube management at home
• Use cough assist machines for our clients for airway clearance at home
• Palliative care services at home
• Ventilator weaning at home

We’re also sending our critical care nurses into the home for emergency department bypass services. We have done so successfully as part of the Western Sydney Local Area Health District, their in-touch program, saving approximately $2,000 per patient that we keep at home, instead of them going to an emergency department.

That also means, we’re also in a position to cut the cost of an intensive care bed by around 50%. An intensive care bed costs between $5,000 to $6,000 per bed day. Our services costs between $2,500 to $3,000 per bed day, and we’re freeing up the most sought-after bed in the hospital, which is the ICU bed. Most importantly, we’re improving the quality of life for patients and their families, which is a win-win situation for all stakeholders. Of course, quality of life is much improved surrounded by families instead of staying in an intensive care unit.

With Intensive Care at Home, we are currently operating all around Australia in all major capital cities as well as in all regional and rural areas. We’re a NDIS (National Disability Insurance Scheme) approved service provider all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, and Department of Veteran Affairs (DVA) all around Australia. Our clients and we, as a service provider, have also received funding through public hospitals, private health funds, as well as Departments of Health.

We are currently the only service provider in Australia that has achieved third-party accreditation for Intensive Care at Home nursing in 2025. We have been achieving this level of accreditation since 2012. No other provider in Australia has created more intellectual property when it comes to Intensive Care at Home nursing than we have. This puts us in a position to employ hundreds of years of critical care nursing experience combined in the community. No other service provider in 2025 employs a higher skill level in the community than we do, which enables us to look after the highest acuity adults and children in the community in Australia safely.

If you’re at home already and you’re watching this, or you’re stuck in an ICU, or if you’re going to the hospital and ED all the time and you realize that you don’t have the right level of support at home, or if you’re living in an ICU, I’ll give you another tangible and real-world example today.

One of our first clients when we first got started in 2012, was a client who was at home initially on a ventilator with a tracheostomy with a support worker model 24/7. Of course, support workers are not equipped to look after a client at home on a ventilated and tracheostomy client. That is dangerous and it’s negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy. It’s like flying the airplane with the cabin crew instead of the pilot, because anyone on a ventilator with a tracheostomy is at very high risk of medical emergencies 24/7, or even at risk of dying if they don’t have a team of critical care nurses looking after them 24/7 at home. This is actually evidence-based and is documented in our Mechanical Home Ventilation Guidelines that you can find on our website at intensivecareathome.com.

Think about it, in an intensive care unit in a hospital, you wouldn’t have support workers looking after your critically ill loved one or after any critically ill patient on a ventilator with a tracheostomy. So, why would anyone in their right mind do that in a home care environment in the community?

So, this client found out about us eventually and the ICU that he went back to all the time also knew about us and eventually reached out to us. We were proving our concept with this client very fast. When we worked with this particular client, we sent him intensive care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we working with this client.

We can do the same for you if you’re not safe at home and help you with keeping you at home predictably. Otherwise, we would not be in business. The same is applicable for those stuck in an ICU, similar to our case study that I’ve given you, or if you’re going back to ED all the time, please reach out to us. We can help you with taking you through the right steps including how to get funding with different funding bodies.

This is also why we are providing Level 2 and Level 3 NDIS Support Coordination. We have a team of NDIS Support Coordinators, and they have a wealth of knowledge. I’ve done an interview with Amanda Riches, one of our NDIS Support Coordinators, and I’ll put a link to an interview with Amanda in the written version of this blog. We’re also providing TAC case management in Victoria.

If you’re a NDIS Support Coordinator or a case manager from another organization watching this, and you’re looking for nursing care for your participants, please reach out to us as well. If you need more evidence for nursing care, we are also writing NDIS nursing assessments with legal nurse critical care consulting nurses.

If you are a critical care nurse and you’re looking for a career change, and you want to join a very progressive, dynamic, and high performing team of critical care nurses in the community, we’re employing hundreds of years of critical care nursing experience combined. You can join this high performing team.

If you’re looking for a career change, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, Bendigo, in Geelong, and in Warragul in Victoria. If you have worked in critical care nursing for a minimum of 2 years pediatric ICU, ED, and you have already completed a postgraduate critical care nursing qualification, we will be delighted hearing from you.

I do have a disclaimer though, because we are offering a tailor-made solution for our clients, which includes regular staff, our clients also do want the same staff coming over and over again because they are so vulnerable and so special, and that’s why we need regular staff. So, if you’re looking for agency work where you can come and go, this will not be the right fit for you. We are looking for consistency and our clients are looking for consistency. So please, only apply with us if you can give us regular and consistent availabilities for shifts and you’re really keen on building solid relationships with us and with our clients.

If you are an intensive care specialist or an ED specialist, we also want to hear from you. We’re currently expanding our medical team as well. We can also help you eliminate your bed blocks in your ICU and in your ED for your long-term patients, or for your regularly readmitting patients with our critical care nursing team at home. We’re here to help you take the pressure off your ICU and ED beds. In most cases, you won’t even pay for it. Even if you do pay for it, it is so much more cost-effective than what you’re paying for in ICU and ED, and you get the same level of care.

If you’re a hospital executive watching this and you have bed blocks in your ICU, ED, and respiratory wards, or home TPN, please reach out to us as well. We can help you eliminate your bed blocks very fast.

If you’re in the U.S. or in the U.K. and you’re watching this and you need help, we want to hear from you as well. We can help you there privately with one-on-one consulting and with hiring nurses privately.

Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

If you like my videos, subscribe to my YouTube channel for regular updates for families with Intensive Care at Home and intensive care. Click the like button, click the notification bell, share this video with your friends and families, and comment below what you want to see next or what questions and insights you have from this video.

Thank you so much for watching.

This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.

Take care for now.