Framework can help hospitals keep ventilated patients safe

After recognizing high rates of airway complications among mechanically ventilated COVID-19 patients, a team at the University of Pennsylvania Health System, Philadelphia, devised the I-READI conceptual framework to help health care organizations respond to quality and safety challenges during crises or periods of capacity strain. Root cause analysis and evidence review framed their practice adaptation, ensuring they prioritized patient and health care worker safety. Under their revised guidelines, the rate of endotracheal tube obstruction among mechanically ventilated patients with COVID-19 decreased from 9.2% to less than 1%, and reintubation rates decreased from 36% to 9%. (NEJM Catalyst case study, January 2021)