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“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 the last few months. It’s quite an in depth survey about tracheostomy care in hospitals, but also in the community. Whilst it has a lot of depth in terms of the issues, it lacks solutions, but that’s what we are here for at intensivecareathome.com.

By the way, my name is Patrik Hutzel from intensivecareathome.com. So, it’s a multi-part series here about this survey that I’m breaking down section by section. In the last blog, I talked about the discussions  that came out of the perceived affordability. As I go on section by section in this survey, I offer our solutions, because, like I said, the survey is pretty good in terms of asking the right questions, but it absolutely lacks creativity, and it absolutely lacks solutions for the real world. We’ve been in the real world with Intensive Care at Home, with tracheostomy clients since 2012. We actually know what real solutions look like to get patients home from ICU.

So, today, let’s look at the section in the survey about workforce competency and education gaps. The survey says,

The most pressing concern identified was the limited availability of healthcare practitioners with specialized tracheostomy expertise, with a median severity score of 8. Nearly half of respondents cited a lack of optimal educational resources and emergency training scenarios, while others emphasized the absence of a standardized curriculum for tracheostomy care.

Let’s just pause there. Well, limited availability of healthcare practitioners with specialized tracheostomy expertise, once again, we have a solution for that because all of our critical care nurses are tracheostomy competent because they have worked in critical care and intensive care for a minimum of 2 years, that’s number one.

Number two, where the survey also lacks depth is what we do is actually evidence-based. When you look at our website at intensivecareathome.com, you will find a section, the Mechanical Home Ventilation Guidelines . The Mechanical Home Ventilation Guidelines are evidence-based and they clearly recommend that exclusively critical care nurses with a minimum of 2 years critical care nursing experience with a postgraduate qualification can look after ventilated and tracheostomy clients in the community. That is the gold standard, and there is no room for negotiation. That is what we’ve been doing since 2012 at Intensive Care at Home.

Now, those evidence-based Mechanical Home Ventilation Guidelines come out of over 25 years of Intensive Care at Home nursing, starting out in Germany in the late 1990s, and then continuing with Intensive Care at Home in 2012 in Australia, so it’s all evidence-based.

Let’s get back to the survey,

Speech-language pathologists and respiratory therapists were most likely to report these challenges, reflecting their frontline roles in managing complex tracheostomy cases.

I can see the frustration here from speech pathologist and respiratory therapists, in particular. If they’re not surrounded by ICU nurses, yes, they would find that challenging. And again, this is the level of expertise we are bringing into the community.

The survey continues,

Barriers to competency were compounded by staff shortages, high training costs, and insufficient opportunities for ongoing education.

Once again, that’s why we exclusively employ critical care nurses with a minimum of 2 years critical care nursing experience. More than 50% of our staff have a postgraduate critical care qualification, which is actually what’s needed when it comes to Intensive Care at Home services in the community.

Again, do we provide ongoing opportunities for education for our staff? Of course, we do. We have a below industry average staff turnover, so we must be doing something right. We’re not perfect by any means, but we must be doing something right so that staff actually stay with us.

The survey continues,

Resistance to adopting evidence-based practices, such as one-way speaking valves or cuff deflation, further hindered improvements in care delivery.

Of course, because if you don’t have an educated workforce, you get substandard service delivery. Makes sense.

The fear and lack of experience among caregivers for tube changes, as well as the inadequate training for healthcare practitioners, complement prior research focusing on the importance of caregiver training and support networks.

Once again, of course, caregivers can’t manage tube changes if they’re not intensive care trained, makes perfect sense, and of course the training is inadequate if people haven’t worked in intensive care for prolonged periods. Tracheostomy device is an artificial airway, it can’t be managed just by anyone.

These issues further highlight the need for comprehensive educational interventions that address both healthcare practitioners and caregiver preparedness. In addition, retention of experienced nurses and staff plays a vital role in promoting comfort and competency in tracheostomy care.

Of course, it does. And again, this is why I’m proud to say that we have a below industry average staff turnover for our critical care nurses and we want to keep it that way.

Without adequate retention strategies, the healthcare system risks exacerbating workforce shortages and losing valuable expertise critical to managing complex tracheostomy cases.

That is absolutely correct. It is vital to keep your workforce happy and satisfied with the work they’re doing. With Intensive Care at Home, I do believe we are purpose-driven and we are on a mission, and that’s why I believe people want to be part of that mission and that purpose. That’s one of the reasons why I believe they’re staying with us.

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].

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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.