Centers of Excellence

Children’s Hospital of Wisconsin

Children's Hospital of Wisconsin team

Children’s Hospital of Wisconsin (CHW), a medical college-affiliated quaternary pediatric care center, established its Tracheostomy and Home Ventilator Program in 1984 and has served over 800 children who are tracheostomy-dependent. Their multidisciplinary approach and commitment to the highest quality of care makes their program the premier tracheostomy and home ventilator program in the region. As the premier program in the region, they cared for 206 children with tracheostomies in 2016, 50% of whom depended on home mechanical ventilation (HMV). This data from 2016 is representative of the care they provide to children with tracheostomies each year.

Their pediatric multidisciplinary team consists of pulmonologists, otolaryngologists, respiratory therapists, advanced practice nurses, nurse clinicians, registered nurses, speech-language pathologists, nutritionists, and social workers. The Passy Muir® Valve (PMV) has been part of the care for children at CHW for over 15 years. Historically, the PMV was limited to children who were on trach collar. In 2014, the CHW program expanded their practice to include PMV for children with home mechanical ventilation (HMV), whose settings met the Policy and Procedure criteria for PMV use in-line with mechanical ventilation. In 2015, a PMV Quality Improvement (QI) project demonstrated that the rate of PMV evaluations occurring prior to initial hospital discharge was 90%. Interventions to improve PMV use included intensive PICU staff education and discussion of PMV evaluations in the multidisciplinary rounds happening prior to initial hospital discharge.

The Tracheostomy and Home Ventilator Program at CHW includes nationally ranked physicians and multidisciplinary team members who provide inpatient care, as well as outpatient treatment in dedicated trach and vent clinics. Education is provided for children and their families, as well as medical providers, locally and nationally. CHW conducts community education programs and professional training, including classes for pediatric tracheostomy and vent certifications.

CHW is involved in local and international organizations promoting quality tracheostomy care for children. Their QI and research efforts dedicated to improving care for children with tracheostomies have been presented at national conferences and published in peer-reviewed journals. The Tracheostomy and Home Ventilator Program is part of the Division of Pediatric Pulmonary and Sleep medicine, which has been named among the nation’s best in the U.S. News & World Report Best Children’s Hospital report.

Success Stories


Policies and Procedures

Children’s Hospital and Health System Patient Care Policy and Procedure

Additional Documents

Children’s Hospital of Wisconsin PMV Teaching Sheet

Children’s Hospital of Wisconsin PMV Education Slides

PMV Process Flowchart