Quality Reports - Tracheal Surgery

Tracheal Surgery Volume

Why we measure it - Research shows that physicians and hospitals that treat a large number of patients tend to provide better care and have improved outcomes for treatments and procedures. Tracheal stenosis (narrowing of the airway) is a rare and potentially life-threatening condition. It can be treated surgically by a team of specialists and careful monitoring before and after surgery.

Patient Impact   At just two weeks old, Noah was admitted to Children's Hospital because he had trouble breathing and his pediatrician detected a heart murmur. Our specialists found he had severe tracheobronchomalacia and a congenital heart defect. At one month old, surgeons repaired his heart and trachea using a pioneering surgical technique called tracheopexy. Now six months old and thriving, Noah receives follow-up care at Children's Hospital every four months.

What this means - Tracheal surgeries are very rare. Children's Hospital has one of the only programs in the country specializing in tracheal surgery.

About the data - The data represents the number of surgeries performed involving the airway at Children's Hospital for the calendar years 2005-2009. These include tracheoplasty, tracheo- or broncheopexy, and vascular ring and sling repairs.

Related dimensions of care:

What we're doing to provide the best care:

• Children's Hospital surgeons have developed innovative techniques, such as tracheopexy, to improve outcomes and avoid tracheostomy in these complex patients.
• Approximately 40 percent of patients with a tracheal disorder also have a congenital heart defect. Patients benefit from skilled Herma Heart Center specialists, know nationwide for their expertise in cardiothoracic surgery.
• We have the only cardiothoracic surgeons in the state of Wisconsin with American Board of Thoracic Surgery Certificates in Congenital Heart Surgery.
• Patients receive comprehensive care from a dedicated tracheal services team, including specialists in pediatric cardiothoracic surgery, pulmonology and radiology. This multidisciplinary team meets regularly to develop individual plans of care for each patient.
• A specialized nurse coordinator provides case management services for every patient with a complex tracheal disorder. Comprehensive case management allows for seamless care coordination between specialists, facilitates medical record acquisition, and streamlines follow-up plans and scheduling.
• Following surgery, patients receive care in our Airway, Digestive and Voice Center where tests such as bronchoscopies and bronchograms provide detailed airway images. These images allow specialists to monitor progress and quickly diagnose and treat any potential problems.
• To improve patients' quality of life, a Developmental Follow-up Program also is available. A team of specialists, including physicians, nurses and occupational, physical and speech therapists specialize in assessing a child's growth and progress.
• We have pediatric-trained anesthesiologists, which is essential in such complex surgeries.
• Children recover in our cardiac intensive care unit where they receive the highest level of care possible by pediatric-trained nurses and physicians.
• Our specialists have been trained by experts from England and continue a relationship with the Great Ormond Street Hospital, currently the largest center in the world for tracheal surgeries.
• We conduct genetic research to determine the root cause of these problems, as well as quality of life studies to ensure children develop to their fullest potential. Current studies include management and outcomes for vascular rings and slings, impact of tracheopexy on tracheomalacia and airway outcomes, standardized clinical follow-up of slide tracheoplasty patients, association of 22q11.2 deletion syndrome with vascular anomalies, and genetic analysis of tissue from patients with congenital tracheal stenosis.
• We have a highly specialized Children's Transport Team available 24 hours a day to stabilize and transport seriously sick and injured infants and children to our center. Nearly 1,500 transports are provided each year. 
• We offer the Family Accommodations Program to help make travel arrangements and coordinate appointments for families traveling to our center from a long distance.
• For patients who require a tracheostomy tube, we have two nurses dedicated to the care of tracheostomy patients from surgery through long-term follow-up. A discharge coordinator also helps arrange for home nursing care for patients.

Patients/Families:

• Be an advocate for your child. Participate in daily bedside clinical discussions and provide any information about your child that may be helpful to staff.
• Follow medical instructions fully and carefully before and after surgery.
• Ask questions if you don't understand the plan of care or if you are not sure how to care for your child at home.
• Attend any and all follow-up appointments.

If you have questions about this data or information, e-mail us or call (414) 266-6556.