Center of Excellence Request

To submit an application, please email coe@passymuir.com with the information below.

Contact Information:

  • Full name
  • Professional title/discipline
  • Email address
  • Phone number
  • Facility/organization name
  • Complete facility address

 

Facility Information:

Please provide information about your facility and tracheostomy program, including:

  • Type of facility/organization
  • Patient population served
  • Patient Education Handout Sample
  • Approximate number of patients with tracheostomies served
  • Disciplines involved in tracheostomy care
  • How Passy Muir Valves are incorporated into patient care
  • Information about your facility’s multidisciplinary approach to tracheostomy care
  • Any established protocols, policies, or procedures related to Passy Muir Valve use

 

Education & Program Information:

Please describe:

  • How your facility provides education and training related to tracheostomy and Passy Muir Valve use
  • How patients and families are educated
  • How your team promotes collaboration among disciplines
  • Any initiatives, programs, outcomes, or accomplishments that demonstrate excellence in tracheostomy care

 

Required Documents:

Please include the following required documents. When naming your files, please adhere to the following procedure. Begin with COE, then an underscore followed by your facility name, then another underscore followed by the date of submission. Example: COE_Barlow_4.23.2019 If you are sending more than one file, begin numbering before the first underscore. Examples: COE_Barlow_4.23.2019 COE2_Barlow_4.23.2019

  • Team Photo (Names, credentials, and titles of persons pictured in team photo)
  • Consents for every person used in any uploaded media. Download the consents form here, then scan to PDF or graphic file.
  • Facility Passy Muir Valve policy and procedure (including use of a PMV for patients on mechanical ventilation, if those patients are served in the facility).
  • Team members resumes or curricula vitae and a 50-word bio of each team member. These should provide evidence of their qualifications to work with patients following tracheostomy or mechanical ventilation.

 

Please send your request to coe@passymuir.com with “Centers of Excellence” in the subject. Our team will follow up regarding your application.