[AVBC 2025] Value of Task-Shifting in Tracheostomy Management: A Physiotherapist-Led Multidisciplinary Team
Care Process & Redesign
Workforce Transformation
Appropriate & Value-based Care Conference
National Healthcare Group
11 December 2025
To evaluate the feasibility, effectiveness, and value of a task-shifting model in tracheostomy care, transitioning from a. This pilot demonstrated favourable clinical and economic outcomes, supporting the feasibility of a physiotherapist-led MDT model for.
Year Submitted: 2025
Published Date: 11 December 2025
Tags: Care Process ＆ Redesign, Workforce Transformation, Workflow Redesign, Quality Improvement, Productivity, Cost Saving, Time Saving, Job Redesign, Upskilling, Multi-Disciplinary
About this Content
Aims
To evaluate the feasibility, effectiveness, and value of a task-shifting model in tracheostomy care, transitioning from a physician-led approach to a structured, physiotherapist-led multidisciplinary team (MDT) model in a tertiary hospital.
Background
Tracheostomy care is complex and often under-prioritised, requiring coordinated input from multiple disciplines. Although effective, multidisciplinary models remain underutilised locally. Given constraints on physician-led coordination and emerging evidence for allied health-led care, a physiotherapist-led MDT may offer a sustainable approach to enhance continuity, efficiency, and quality of care for tracheostomized patients.
Methods
This new model in tracheostomy care was piloted from July to December 2024, targeting newly created tracheostomized patients, excluding those ventilated or under direct otolaryngology care. Operating with clinical autonomy under indirect supervision, cardiopulmonary-trained physiotherapists screened and provided longitudinal care until decannulation, discharge, or resolution of tracheostomy-related issues. They coordinated and led weekly MDT rounds to establish weaning goals and care plans. A quasi-experimental design compared standard physician-led care (historical control; August 2022June 2024) with this new model.
Results
Twenty-eight patients with new tracheostomies were evaluated. While decannulation rates were comparable between groups (55% vs. 54%), the intervention group achieved significantly earlier weaning milestones: transition to cuffless tubes (-9 days), use of speaking valves (-4 days), and return to functional oral intake (-28 days), all p0.05. Adjusted post-ventilation median length of stay decreased by 17 days (p=0.008), with a five-day overall stay reduction (p=0.321), most notably in neurologically impaired patients. Total hospitalisation costs decreased by 22.6%, with projected savings of $52,868 per neurological case. Safety was maintained with no failed decannulations, otolaryngology referrals, or mortality increase.
Conclusion
This pilot demonstrated favourable clinical and economic outcomes, supporting the feasibility of a physiotherapist-led MDT model for tracheostomy care. The initiative reflects task shifting and showcases allied health leadership in services traditionally directed by physicians. It offers a replicable, value-based care model for future team design.
Lessons Learnt
The pilot demonstrated the feasibility and effectiveness of a physiotherapist-led MDT model in tracheostomy care, highlighting the potential for task shifting and allied health leadership in traditionally physician-directed services.
Keywords
tracheostomy, physiotherapist, multidisciplinary, task-shifting, care model
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Allied Health |
Applicable Specialty or Discipline | Rehabilitation Therapy |
Project Lead(s) | Ting Sye Jin Jennifer |
Project Member(s) | Ting Sye Jin Jennifer |
Connect with this contributor!
Ting Sye Jin Jennifer - jennifer.sj.ting@nhghealth.com.sg