Reducing Unplanned Extubations: Physicians Driving Change

In this 10-minute podcast, Drs. Neal Maynord (Assistant Professor of Pediatrics and Director of Quality for Critical Care Medicine at Monroe Carell Jr. Children’s Hospital at Vanderbilt) and Kristin Melton (Associate Professor of Pediatrics and a practicing neonatologist at Cincinnati Children’s, where she serves as the Associate Medical Director for the NICU and the Fellowship Director) share how they have helped drive change as physicians and lessons they have learned from colleagues across the country. Dr. Maynord highlighted the importance of enforcing with staff that unplanned extubations matter. He noted, “They are harmful, they are avoidable, and they are expensive.” Dr. Melton shared, “Physicians can play a significant role in helping the team understand why we care.”

Dr. Melton emphasized the importance of a multidisciplinary team approach for UE prevention, and the physician plays an important role in engaging that multidisciplinary team. Dr. Maynard encouraged physicians to be involved, be encouraging, and help co-lead RCAs and the educational processes that are needed to maintain this kind of work.

Importantly, Dr. Melton concluded, “We’ve seen in our data that hospitals that have been working on this continue to show improvement, and one of the ways they are showing improvement is going back to the basics and making sure that they are really doing the right thing every time and that we’re reinforcing to our staff that they’re doing things well.”

Reference: Roddy DJ, Spaeder MC, Pastor W, Stockwell DC, Klugman D. "Unplanned Extubations in Children: Impact on Hospital Cost and Length of Stay." Pediatr Crit Care Med. 2015 Jul;16(6):572-5.