THE Anaesthesia team at Manchester University NHS Foundation Trust (MFT) have won the Anaesthesia and Perioperative Medicine Team of the Year award at the prestigious BMJ Awards 2020, recognising their outstanding dedication to ‘Improving Tracheostomy Care’ for patients across Greater Manchester and beyond.
The team work across Wythenshawe Hospital, Royal Manchester Children’s Hospital (RMCH) and Manchester Royal Infirmary, all part of MFT, in the community, and also support training and care in non-tertiary centres across the UK.
Until recently, there was no universal package of guidance for staff to treat patients fitted with a tracheostomy. Over the last six years, clinicians at MFT have worked to improve patient safety, patient experience and collaborative care, sharing their learning with hospitals across the UK.
Tracheostomies are small tubes inserted into the neck acting as artificial airways, with around 20,000 new tracheostomies inserted annually in the UK. The needs of a tracheostomy patient are often complex and are dependent on competent, knowledgeable care to keep them safe.
Historically tracheostomies were performed by head and neck surgeons and mostly managed on surgical wards. Alongside this surgical workload, around 70% of tracheostomies are now carried out by anaesthetists or intensive care specialists on intensive care units, creating a new group of complex patients recovering from critical illnesses.
Brendan McGrath, Consultant Anaesthetist at MFT and NHS England and NHS Improvement’s advisor on the National Patient Safety Improvement Programmes, and his team have led on local and national studies identifying recurrent problems with tracheostomy care.
In 2014, the team at MFT initiated a pilot study in four NHS Trusts in Greater Manchester. The improvement project has now been rolled out to 20 diverse UK hospitals following the pilot from 2016. The programme includes standardising care and providing training for more than 4,000 members of staff.
Dr Brendan McGrath, Consultant Anaesthetist at MFT said: “We are proud to be leading the way in tracheostomy care and improving the quality of care for our patients, and sharing our learning with hospitals across the UK. Patients and their families have been at the heart of our programme of improvement and they have been involved in all aspects.
“We are delighted to have won this award and it is a mark of real achievement for the whole team involved – doctors, nurses, allied healthcare professionals and of course, our patients. This project really showcases how we can all work together across diverse sites and the many specialties involved in tracheostomy care to improve the safety and quality of care for some of our most vulnerable patients.”
The three year improvement programme has reduced the harm from incidents by 55% and has resulted in higher quality care, with a 47% reduction in patient reported anxiety and depression. Patients also talk, eat and drink significantly earlier since the introduction of the programme.
The better care led to estimated savings of £30,000 per patient episode and estimated potential saving of up to £275 million across the country.
Key patient safety elements of the programme have been adopted by the National Patient Safety Improvement Programmes and are being spread across the NHS in England.
Dr McGrath has also established the UK National Tracheostomy Safety Project with MFT colleagues, designing educational resources and multidisciplinary quality improvement programmes.
He continued: “Patients told us that their main worries were around eating, drinking and talking, which is one of the reasons behind the creation of more than 50 short educational videos for patients, families and healthcare staff.”
Following the successful implementation of films made with adult tracheostomy patients, viewed by more than one million people worldwide, the team developed and filmed a set of 25 educational videos for paediatric tracheostomy patients at RMCH, with a red-carpet premiere for the patients and staff involved.
Brendan and his team have also led on setting up the Global Tracheostomy Collaborative which shares good practice from exemplar hospitals around the world and evaluates the impact of improvements. MFT was the first Trust in Europe to join the initiative and the team’s work in Manchester remains pivotal in improving the quality and safety of care for patients.
Tim Keeler, Chief Executive of Clinical and Scientific Services at Manchester University NHS Foundation Trust said: “I am incredibly proud of our Anaesthesia team at MFT who go above and beyond to improve patient safety and provide collaborative care across a number of our hospitals for the benefit of our patients in Greater Manchester and beyond.
“The team are truly leading the way in tracheostomy care, not only across the UK but globally, and what they have achieved is outstanding. This recognition from the BMJ is very well deserved.”
This year, the BMJ Awards took place virtually on Wednesday 7th October with the winners announced online. Now in their 12th year, the awards recognise the professionalism, commitment, creativity, and hard work of healthcare teams across the UK.
You can learn more about the team’s work at www.tracheostomy.org.uk.