Education & Care Gaps in Tracheostomy Management: A Multi-Stakeholder Survey – Conclusions

“Addressing Education and Care Gaps in Tracheostomy Management: Insights from a Multi-Stakeholder Global Survey.” That is what the Global Tracheostomy Collaborative has published on their website in recent months. It’s a very long survey, and I’ve broken this survey down section by section here in my intensivecareathome.com videos.

My name is Patrik Hutzel from intensivecareathome.com.

Today, I want to look at the last part of the survey about the Education and Care Gaps in Tracheostomy Management: Insights from a Multi-Stakeholder Global Survey, it’s about conclusions, and I’m going through that today. I’ve also linked to the study in the written version of this blog so you can have a look at the study yourself. Study is giving a lot of details, but it lacks solutions, which is what we are having here at intensivecareathome.com.

This study has been done in 2025. We’ve been providing Intensive Care at Home for tracheostomy clients in the community since 2012. So, we’ve been thinking this through way before this survey has come out, but as I’ve gone through the study, I’ve been breaking it down one by one and offered our solutions that we’ve had in place since 2012.

So, let’s look at the conclusions of the study.

This study highlights critical challenges in tracheostomy care, including workforce shortages, inequitable access, affordability issues, and gaps in caregiver support.

I say, well, we’ve got that figured out already. So, we don’t need to study for that, we’ve just observed in ICUs, because we’ve got a critical care nursing workforce in the community, what is needed in the community and we’ve put it in place. We didn’t need to study for that. We just opened our eyes and made it happen.

Workforce shortages, well, we have a below average staff turnover compared to hospitals, so that means people want to work for us, and I’m very proud to say that.

Inequitable access, I think we’ve sorted that out by advocating for our clients and by helping them with some of the funding that’s needed.

Affordability issues, it’s not an affordability issue. It’s about a business model. If an ICU bed costs $5,000 to $6,000 per bed day, and we can cut that cost by half, then the Intensive Care at Home makes a lot of sense.

Tracheostomies, whether with or without ventilation, can only be looked after by critical care trained nurses, which is evidence-based, by the way. If you look on our website at the Mechanical Home Ventilation Guidelines, which are evidence-based, you will find that only critical care nurses with a minimum of 2 years critical care nursing experience are safe to look after tracheostomies and ventilation in the community. Like I said, our services are evidence-based. We didn’t need a survey to put them in place. We just opened our eyes and see what’s happened in ICU and in hospitals.

The survey continues.

Addressing these issues requires urgent action, starting with the development of scalable, standardized training programs to enhance workforce competency.

Once again, we’ve been doing that since 2012 by putting policies, procedures in place for tracheostomy and ventilation in the community, developing Intensive Care at Home into a real solution for our clients, but also for hospitals.

The survey continues.

Policymakers and healthcare leaders should prioritize equitable resource allocation to improve access to care and alleviate financial burdens on patients and caregivers.

Once again, clearly, if we cut the cost of an ICU bed by 50%, it does alleviate the financial burden on patients, caregivers, and also on hospitals and funding bodies.

Expanding simulation-based training and piloting innovative educational technologies, such as VR (virtual reality) and AR (augmented reality), can provide immediate solutions while paving the way for long-term advancements. Collaborative, interdisciplinary approaches remain essential for ensuring quality and safety in tracheostomy care.

Yes, absolutely! It really does, and we are collaborative. We’re working with hospitals, we’re working with intensivists, we’re working with all the stakeholders that are needed to provide quality care for tracheostomy and ventilated patients in the community, adults and children.

Future initiatives should focus on fostering partnerships among stakeholders, including healthcare providers, caregivers, and policymakers, to implement these targeted interventions and bridge gaps in care delivery, particularly in underserved communities.

Well, once again, I do believe we have been advocating for underserved communities and we are providing services in those underserved communities.

Now, when you look at the survey, there’s a whole list of references. I’m surprised they haven’t put the reference in there for the Mechanical Home Ventilation Guidelines on our website. But I guess, the Global Tracheostomy Collaborative might still be learning about what’s really happening in the community in particular and what standards need to be implemented that are actually evidence-based.

So, I want to conclude this multi-stakeholder survey now.

We’ll be back in the next blog with questions that we get from clients, go back to the regular sort of content, but I also believe that it was very important to break this survey down and offer solutions for the tracheostomy community in and out of hospitals.

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 and by a team of dedicated intensive care nurses in the home care setting instead of 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 work with NDIS (National Disability Insurance Scheme) clients all around Australia, TAC (Transport Accident Commission) and WorkSafe in Victoria, 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 having policies and procedures for Intensive Care at Home nursing and we’ve built all the intellectual property for Intensive Care at Home 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 long-term, 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 are stuck in an ICU, I’ll give you a real-world example today, how we can help you.

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 ventilator with a tracheostomy. That is dangerous and it’s simply negligent. Having support workers looking after a client at home on a ventilator with a tracheostomy is like flying the airplane with a 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 high risk of dying if they don’t have a team of dedicated 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 the home care environment in the community?

So, this client at the time found out about us eventually, and the ICU that he was basically living in 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 critical care nurses, 24 hours a day. He never ever went back into ICU ever again, as long as we were 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. Again, the same is applicable for those stuck in an ICU, similar to this case study that I’ve just 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 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 and WorkSafe case management in Victoria with Lucy McCotter.

If you’re an 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 are a critical care nurse.

If you are looking for a career change as a critical care nurse, we’re currently hiring for jobs for critical care nurses in Melbourne, Sydney, Brisbane, in Albury, Wodonga, in Bendigo, in Geelong, 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. 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’re 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 for 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. and 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].

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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.