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“Addressing Education and Care Gaps in Tracheostomy Management: Insights from a Multi-Stakeholder Global Survey” from the Global Tracheostomy Collaborative.

So, I’ve been dissecting this survey in my recent videos, and it’s quite a long survey. Thank you to the Global Tracheostomy Collaborative for putting this survey on their website. It gives me an opportunity to respond to that survey and actually offer solutions. While the survey gives a lot of insights from health professionals, but also from families, what is required in the tracheostomy space, especially in home care, there’s no solutions offered. Whereas we at Intensive Care at Home, and you can find more information at intensivecareathome.com, we have, I believe, most of the solutions that are required to manage tracheostomies in the community in particular.

Today, I want to discuss the section of affordability, and I will also link to previous discussions that I had about this survey so you can get the solutions that Intensive Care at Home offers for any client in the community with tracheostomy and plus minus mechanical ventilation.

So, today I want to look at the affordability section of the survey and I’m also linking to the survey, of course, as part of this video.

Survey says,

Affordability challenges were led by costs in the community, including supplies, equipment, and loss of income. Speech-language pathologists and respiratory therapists reported these issues most frequently. Prolonged length of stay costs were highlighted by nurses and speech-language pathologists. Similarly, readmission costs and ventilator-associated pneumonia/complication costs were major concerns, with speech-language pathologists and respiratory therapists reporting the highest proportions (up to 39.5% for complications).

Let’s just break this down here, because again, that’s where we have solutions. Loss of income, especially for families that put everything on hold and “live” in hospitals or live in ICU. Well, again, with Intensive Care at Home, we provide intensive care services at home that are evidence-based. Therefore, by us taking a tracheostomy patient home, for example, families can go back to work. That’s what I’m saying, we have a solution for everything here.

Also, prolonged length of stay costs, we all know that an ICU bed costs between $5,000 to $6,000 per bed day. Intensive Care at Home cuts that costs to about half of that, $2,500 to $3,000 a day. We’re freeing up the most sought-after bed in a hospital, which is the ICU bed. It’s a win-win situation all around.

Next, readmission costs and ventilator associated pneumonia. Well, readmission costs, again, our clients do not go back to hospital, generally speaking. Ventilator associated pneumonia because again, an infection in a home care environment is much less likely to happen compared to hospital environment. So, the people from the survey have not even thought through what the answers are to these solutions.

Additionally, 17 respondents (10%) shared further concerns in free-text responses, such as inadequate insurance coverage for tracheostomy care and medications…

So, I’ll stop right here because once again it all depends on your pitch. What I mean by that is, well, insurances pay for $5,000 to $6,000 per bed day in an ICU bed. Most tracheostomy patients would be in ICU beds. Again, it all comes down to create a win-win situation, which is what we do here at Intensive Care at Home. We create win-win situations. We cut the cost of an ICU but by 50%, win for the insurance, and win for the hospital. ICU gets a free bed, families can be at home, which is where they want to be; patients want to be at home, which is where they want to be. It’s a win-win situation all around.

No one in this survey is actually thinking outside of the box, and I don’t think what we do is thinking outside of the box, we just do what we believe is what patients and families want, but also what hospitals want.

Survey continues,

…challenges in securing long term acute care hospital, which is in the U.S. mainly, or skilled nursing facility placement for underinsured patients, once again, that’s in the U.S. mainly, lack of care options for undocumented individuals, and limited government funding.

Again, you can get government funding with the right approach with a win-win situation. That’s when the government starts listening as well. Again, we have a win-win situation for everyone here at intensivecareathome.com.

Respondents also mentioned barriers such as Medicaid expansion refusal in certain states in the U.S. like Texas, a shortage of facilities accepting diverse patient needs, lack of fiberoptic evaluation in rehab centers, high caretaker costs…

Again, I stop there, once again, if we’re cutting the cost by 50% of an ICU but it’s not high caretaker because it’s actually costs coming down.

…scarcity of community support for consumable supplies, again, we can organize all of that.

…family travel burdens, once again, we can take care of all of that because we come to our clients’ homes and the heavy caretaking load associated with tracheostomy management. Yes, it is a heavy caretaking, there’s no question about that, but that’s where we come in as the experts.

So next week, we discuss this survey further and we look at identifying other critical gaps in tracheostomy care.

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.