We recently reported on tracheostomy-related outcomes comparing 2 consecutive years before (2011) and after (2012) the introduction of an inline tracheostomy speaking valve (SV) into practice in a primarily cardiothoracic intensive care unit (ICU) [1]. Our results indicated a significantly earlier return to verbal communication for tracheostomized patients after the introduction of an inline SV without effecting ventilator weaning or decannulation time.

The practice of using SVs in our ICU has continued to increase and is now part of standard care with tracheostomized mechanically ventilated patients. After ethics approval, we collated and analyzed similar outcomes of all tracheostomized patients in ICU for the following 2 years (2013 and 2014). Our aim was to assess whether clinical uptake had continued after the initial “honeymoon” phase associated with the original research. Equally, as our process matured, how tracheostomy outcomes had changed.