Single Patient Versus Multi-Patient Emergency Travel Bags for Pediatric Tracheostomy Patients: A Cost Analysis

Abstract

Background: Emergency travel bags (ETB) for pediatric tracheostomy patients (TP) are imperative to reduce potential tracheostomy emergencies1,2. In our pediatric health system, our standard process is for every TP to have a stocked ETB available upon admission. Often times these ETB are left by patients at discharge or not used during the admission. We aimed to transition our single use, single patient (SP) ETB to a multi-patient (MP), reusable ETB to reduce waste and reduce costs.

Methods: A multi-disciplinary team (RT, MD, RN, SLP) was convened to assess the appropriateness of travel emergency bag supplies. After the contents of the ETB were evaluated we were able to remove 35 items from our standard SP ETB model (58 versus 43 items). This included 16 items at various quantities in the single patient model and 12 items at various quantities in the new multi-use model. 22 MP ETBs were created for use on tracheostomy units. Maintenance (ensuring locked, checking inventory, restocking as needed) for the MP ETB is done by RTs after use and on a weekly basis. MP ETB are readily accessible on all tracheostomy units for ease of use.

Results: The cost of our SP ETB was $70.48 each. The new multi-use model had an initial startup cost of $352.00 to purchase the initial 22 bags ($16.00/each). Supplies for the MP ETB cost $44.54. Breakdown of cost based on bag type can be seen in Table 1. An IRB approved retrospective analysis showed that in 2019 our hospital saw 166 trach patients in 212 encounters. With a minimum savings in ETB of $25.94 per bag, minus initial bag cost, this equates to $5,147.28 of savings in 2019 when compared to the SP ETB model. In 2019, there were zero tracheostomy risk related events due to lack of available supplies related to the MP ETB.

Conclusions: MP ETB use in our institution was able to reduce cost without adverse effect to pediatric tracheostomy patients. Further studies must be done to evaluate possible increased cost savings when the ETB is unopened and does not need all items restocked, as well as the long-term safety of MP ETB.