{"title":"Guidance in Tracheostomy Care for Speech-Language Pathologists: The Green Light Tool.","authors":"Sara Penrod, Dory Forgit, Lindsay Griffin","doi":"10.1044/2025_AJSLP-24-00466","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate whether the implementation of the Green Light Tool for the evaluation and treatment of tracheostomy patients hospitalized at Maine Medical Center affects the time to initiating oral nutrition, use of speaking valves, and/or time to decannulation for temporary tracheostomies.</p><p><strong>Method: </strong>This pre-/post-intervention study uses retrospective chart review to collect data pre-intervention (e.g., Time 1) and at two time points post-intervention: 6 and 12 months after the Green Light Tool was implemented (e.g., Times 2 and 3, respectively).</p><p><strong>Results: </strong>Data from 200 participants were included (Time 1: <i>n</i> = 100, Time 2: <i>n</i> = 50, Time 3: <i>n</i> = 50). Participants from each time period were similar along sex, age, and diagnosis. Participants in Time 1 had a statistically significant shorter length of stay compared to participants in Time 2 (adjusted [adj] <i>p</i> = .005) and Time 3 (adj <i>p</i> = .010). Following implementation of the Green Light Tool, speech-language pathologists (SLPs) received assessment consults sooner after a temporary tracheostomy was placed (adj <i>p</i> < .001), and patients with tracheostomies were evaluated by SLPs earlier in their hospitalization (adj <i>p</i> = .006). There was no significant difference on patient-centered outcomes, such as time to speaking valve use, capping trials, decannulation, oral trials, diet initiation, modified barium swallow, or placement of a percutaneous endoscopic gastrostomy tube.</p><p><strong>Conclusions: </strong>Use of the Green Light Tool improved the timeliness and consistency with which SLPs evaluated patients and the self-reported comfort SLPs felt when assessing patients with tracheostomies. Possible reasons for a lack of effect on patient-centered outcomes, including the interference of COVID-19, are discussed.</p>","PeriodicalId":49240,"journal":{"name":"American Journal of Speech-Language Pathology","volume":" ","pages":"2309-2323"},"PeriodicalIF":2.5000,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Speech-Language Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1044/2025_AJSLP-24-00466","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The purpose of this study was to investigate whether the implementation of the Green Light Tool for the evaluation and treatment of tracheostomy patients hospitalized at Maine Medical Center affects the time to initiating oral nutrition, use of speaking valves, and/or time to decannulation for temporary tracheostomies.
Method: This pre-/post-intervention study uses retrospective chart review to collect data pre-intervention (e.g., Time 1) and at two time points post-intervention: 6 and 12 months after the Green Light Tool was implemented (e.g., Times 2 and 3, respectively).
Results: Data from 200 participants were included (Time 1: n = 100, Time 2: n = 50, Time 3: n = 50). Participants from each time period were similar along sex, age, and diagnosis. Participants in Time 1 had a statistically significant shorter length of stay compared to participants in Time 2 (adjusted [adj] p = .005) and Time 3 (adj p = .010). Following implementation of the Green Light Tool, speech-language pathologists (SLPs) received assessment consults sooner after a temporary tracheostomy was placed (adj p < .001), and patients with tracheostomies were evaluated by SLPs earlier in their hospitalization (adj p = .006). There was no significant difference on patient-centered outcomes, such as time to speaking valve use, capping trials, decannulation, oral trials, diet initiation, modified barium swallow, or placement of a percutaneous endoscopic gastrostomy tube.
Conclusions: Use of the Green Light Tool improved the timeliness and consistency with which SLPs evaluated patients and the self-reported comfort SLPs felt when assessing patients with tracheostomies. Possible reasons for a lack of effect on patient-centered outcomes, including the interference of COVID-19, are discussed.
期刊介绍：
Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work.
Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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