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“Addressing Education and Care Gaps in Tracheostomy Management: Insights from a Multi-Stakeholder Global Survey” In this video series, I’ve been talking about this survey from the Global Tracheostomy Collaborative, and this is probably the 5th or the 6th video that I’m making about this because it’s quite a lengthy survey. Thank you for the Global Tracheostomy Collaborative to put it out there to the tracheostomy community or any health professional families that are interested in this space, which we are at intensivecareathome.com.

My name is Patrik Hutzel from intensivecareathome.com. In the last video of this series, I was talking about Barriers to Tracheostomy Care: Insights into Education, Competency. Today, I want to talk about Teamwork and Patient Empowerment.

Whilst the survey is really good in sort of breaking down a lot of issues that are happening with tracheostomy care, whether it’s in hospitals or in the community, I don’t think that the survey really offers any solutions, whereas I believe we have the solutions for tracheostomy and ventilated clients, especially in the community with Intensive Care at Home.

So, let’s look at teamwork and empowerment and see what the survey says. I will also link into my previous episodes, breaking down this survey. You will find those videos and blog posts in the written version of this video blog.

Let’s look at Teamwork and Patient Empowerment.

Key concerns included patients and family members being inadequately empowered or engaged in decisions, reported most by speech-language pathologists and nurses. The lack of a tracheostomy team and personnel to support data-driven practice or benchmarking were also highlighted, with speech-language pathologists and respiratory therapists expressing these challenges most frequently.

I obviously do believe that patients and family members should be empowered in the decision making process because having a tracheostomy and not having a tracheostomy can be quite a big deal, of course, and it can be life changing and life altering. You need to have a plan going forward, especially if patient cannot be decannulated, cannot be weaned off the ventilator

Solutions such as Intensive Care at Home need to be brought into the mix early on so that patients can make an informed decision, of course. By the way, that is why we’re also having another avenue for families to be educated. Have a look at our sister blog intensivecarehotline.com, where we provide consulting and advocacy  for families in intensive care.

So the survey continues,

In free-text responses, 22 participants (13%) identified additional challenges in tracheostomy care. These included shortages of respiratory therapists…

Again, this would be U.S, specific because there are no respiratory therapists in other countries, besides Canada.

…overall staffing limitations, and a lack of trained professionals within the community.

Again, this is exactly where Intensive Care at Home comes in. Like I’ve highlighted in my other videos as part of this video series about the Global Tracheostomy Collaborative survey, we have the solutions in the community for tracheostomy clients with Intensive Care at Home, because we exclusively work with critically care trained nurses with a minimum of 2 years critical care nursing experience. That means all of our staff are actually tracheostomy competent.

Also, our work that we’re doing is evidence-based. Once again, if you look at the Mechanical Home Ventilation Guidelines  at our website at intensivecareathome.com, they’re evidence-based. The evidence clearly highlights that only critical care nurses with a minimum of 2 years critical care nursing experience can safely look after tracheostomy and ventilated clients at home. That’s again, the survey is completely lacking the evidence, because again, we are solution oriented here at Intensive Care at Home.

Back to the survey,

Some respondents cited limited resources to expand staffing and form teams, as well as a need for tracheostomy education for nurses.

Once again, that is all part of what we do. Part of what we do is educating our workforce ongoing education, ongoing training.

Other reported barriers included insurance restrictions, inconsistent infection control practices by healthcare practitioners, language barriers, and insufficient family support.

Once again, they are only perceived barriers because inconsistent infection control practices by healthcare practitioners, once again, because we exclusively work with critically care trained nurses, we have policies, procedures; we manage all of that. We manage all of that safely.

The same with insurance restrictions, they are just perceived. It all depends on how you position the service to an insurance as well. We’re basically cutting the cost of an ICU bed by 50%, so a lot of it comes down to simply doing proper advocacy.

The survey also continues,

Respondents also mentioned the lack of pediatric nebulizer attachments for home care, limited promotion of evidence-based practices…

Again, that’s what I’m doing today. I am promoting evidence-based practices with the Mechanical Home Ventilation Guidelines that I’ll link to in the written version of this blog to our website. That is the evidence that you need for community care, in particular, when it comes to tracheostomy and ventilation.

It also talks about the lack of pediatric nebulizer attachments for home care. It’s unbelievable that patients go home potentially with the wrong equipment or without equipment at all.

The survey also says that evidence-based practices is referring to,

…(such as cuff deflation, swallow studies, and timely downsizing), absence of community teams for long-term care…

Once again, that is exactly what we do here at Intensive Care at Home.

…and variations in tracheostomy management approaches.

Yes, there are some variations in tracheostomy management approaches because a lot of it is simply client-driven in the community but we can adapt to that. The survey lacks in depth in terms of what are you going to do about what people say.

Additional concerns included a shortage of physicians with specialized tracheostomy training, inadequate support at home…

Once again, this is where Intensive Care at Home comes in. We’re also working with the private intensive care specialist who’s overseeing some of our care programs.

…and deviation from best practices to avoid the need for a second tracheostomy placement.

Doesn’t quite make sense what that means even. In any case, so far, when you look at even the other videos, we have a solution for everything that this survey is addressing. We have a solution for everything when it comes to community care and tracheostomy or ventilation and tracheostomy, including non-invasive ventilation.

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.