Centers of Excellence Team Up!

As the team of Gaylord Specialty Healthcare developed a plan to improve their weaning and decannulation outcomes and advance their program through IPE, it was suggested by the Clinical Specialists at Passy-Muir, Inc. that clinicians from Gaylord visit Madonna Rehabilitation Hospital in Lincoln, Nebraska. Madonna Rehabilitation Hospital was the first facility recognized by Passy-Muir, Inc. as a Center of Excellence (see Fall 2010 issue of Talk Muir), for their team’s exceptional approach to the care of tracheostomy and ventilator patients and use of the Passy Muir® Valve. To have two long term care and rehabilitation facilities with the same goals meet and exchange ideas is the ultimate model for interprofessional education and practice.

“To have two long term care and rehabilitation facilities with the same goals meet and exchange ideas is the ultimate model for interprofessional education and practice”

Peggy Bartram, Director of Respiratory Care at Gaylord, approached her administration with this idea and received support, through an educational grant, for her department to send four respiratory therapists (RT) to Madonna for two days of observation and learning. Rebecca Wills, Pulmonary Program Manager at Madonna, was excited about the visit and arranged a tour of the facility, visits with the speech pathology department, and observation and participation in patient care on the units and in the therapy gym.

Lorraine Cullen, Respiratory Supervisor from Gaylord and one of the therapists that made the trip, reported that everyone at Madonna was open to sharing information with them and they admired the “wonderful collaboration of the team at Madonna”. She commented that her staff repeatedly said, “I can’t believe how much we learned while we were at Madonna.” They came back to Gaylord with excitement and eagerness to incorporate change at their own hospital. They immediately went to their speech-language pathologists (SLPs) and told them what they observed in speech therapy at Madonna. Cheryl Tansley, an SLP from Gaylord, has already called Cheryl Wagoner, an SLP at Madonna, and will be incorporating some of what was learned about respiratory and speech collaboration at Gaylord.

The Gaylord RTs also approached their medical director with what they learned regarding in-line Passy Muir® Valve use. Gaylord’s current policy states that patients must be observed by an RT or SLP during in-line valve use. Cullen stated, “We wanted to change that and utilize the approach Madonna takes.” The medical director was willing to listen to us and allowed us to trial this approach on a newly admitted patient. Because this approach worked, Cullen anticipates changing their policy to allow the valve to remain in-line as long as tolerated.

The Gaylord therapists were also impressed by the autonomy of the RT staff at Madonna. Gaylord is working on incorporating weaning protocols and respiratory outcome measurement tools based on information Madonna shared with them. They have met as a group to recap their visit and make a prioritization list of all the information they learned and would like to incorporate into their practice. They have plans to expand their patient education offerings based on what they observed at Madonna. They are also working with their development department regarding some of the hospital initiatives from Madonna that would also benefit Gaylord. Ms. Cullen said, “We have learned so much and truly feel it has invigorated our practice here at Gaylord.”

Click here to download Madonna Rehabilitation’s Tracheostomy Tube Weaning Protocol