Tracheostomy Practice Questionnaire: Development of a Valid and Reliable Tool for Assessing Tracheostomy Practice

Background: Tracheostomy is among the oldest and most common surgical procedures for critically ill patients. Over the past decade, tracheostomy practice has changed regarding its indication, timing, technique, decannulation, and follow-up procedures. A systematic assessment tool for tracheostomy could maximize the quality of care and improve patient outcomes. This study develops a tool for systematically evaluating tracheostomy-related practices, assesses its validity and reliability, and conducts pilot testing of the tool. Methods: The questionnaire development process involved three rounds using the Delphi technique with eight experts in airway management. The experts were selected from multiple healthcare specialties and workplace backgrounds. There was a two-week interval between each discussion round. In February 2019, the questionnaire themes and statements were identified through qualitative content analysis. Subsequently, in March 2019, the developed tool was emailed to 31 heads of tracheostomy care teams at multiple national hospitals for further validity and reliability assessment. Results: The developed tool demonstrated reliability of 0.975. Tracheostomy-related practices showed acceptable levels in all 31 assessed hospitals with areas for improvement in the long-term follow-up domain. Conclusion: This study designed a tool for the comprehensive assessment of tracheostomy-related practices. It can be used to monitor institutional outcomes, which can reduce costs. Moreover, this tool can be employed to track the improvement or deterioration of tracheostomy-related procedures and long-term follow-up to facilitate institutional progress. In addition, this tool could be used for formative and summative assessments of tracheotomy practices at national and international levels.