Abstract
OBJECTIVE: To identify gaps in tracheostomy care related to education, workforce competency, access, affordability, and caregiver empowerment, and to provide actionable insights for improving global tracheostomy practices. DESIGN: Cross-sectional, descriptive study utilizing a global multi-stakeholder survey. METHODS: A 19-item survey, developed collaboratively with healthcare professionals (HCPs), patients, and caregivers, was distributed to members of the Global Tracheostomy Collaborative. Respondents rated tracheostomy care challenges on a severity scale and provided qualitative insights. Quantitative data were analyzed descriptively, while qualitative data were stratified by stakeholder group and thematically synthesized. RESULTS: A total of 170 respondents from 14 countries and diverse professional roles, including speech-language pathologists (30%), nurses (24%), and respiratory care practitioners (24%), identified major challenges. The most critical issues included limited availability of HCPs with tracheostomy expertise (median severity score: 8), inequities in access to care (7), and affordability concerns (6). Key themes included inadequate education and training, inconsistent suctioning and stoma care techniques, and insufficient caregiver empowerment. Barriers specific to underserved populations and resource-limited settings included geographic access limitations, financial strain, and workforce shortages. Respondents emphasized the need for standardized training, simulation-based education, telehealth solutions, and equitable resource allocation to improve care delivery. CONCLUSION: This study highlights significant challenges in global tracheostomy care and emphasizes the need for targeted interventions, such as innovative training frameworks, standardized care pathways, and policy-level changes to address systemic inequities. Enhanced interdisciplinary collaboration and patient-centered approaches are critical for improving outcomes and reducing caregiver burden. Future efforts must prioritize scalable solutions to bridge gaps in underserved and resource-constrained settings.