Project 461095

Patients with serious illnesses often receive a breathing tube in order to survive. If the breathing tube is needed for a long period of time, a breathing tube known as a tracheostomy may be inserted through a surgically made hole in the neck. Patients receiving this are often very ill, requiring care from many different specialists throughout their illness. While in hospital, those unable to access this care have longer hospitalizations, prolonged need for the tracheostomy, and are at greater risk of other health complications. Because breathing and swallowing use the same structures in our body, and even share the same pathways, patients receiving a tracheostomy also often have trouble swallowing. If a patient is unable to swallow properly, this can: delay recovery, make their breathing worse, lead to malnutrition and/or even death. In Canada, many hospitals do not have a process to ensure a swallowing specialist sees all patients with tracheostomy who are at risk for swallowing difficulties. To help ensure that patients receive the care they need, our aim is to engage and consult with patients, families, clinicians and policy makers to find out what is important to them for a clinical care pathway (care map) in this area of medicine. We also will gather all of the best available medical evidence that would outline the best way to care for these patients and eventually inform a care map. Our request is to fund consultations, evidence gathering and the formation of a group of stakeholders invested in helping patients with tracheostomy. This group will be from all parts of the health continuum (from patients to clinicians to policy makers) and geographic areas across Alberta. Through this process we will find out what is important to stakeholders, review the best available information on swallowing following tracheostomy and create a plan for future funding to design a care map and its knowledge to action plan.