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No sponsorships or competing interests have been disclosed for this article. Objective. The purpose of this study was to review inpatients undergoing tracheostomies at a tertiary care pediatric hospital in a 24-month period and to identify the indications, comor-bidities, hospital course, patient complexity, and predischarge planning for tracheostomy care. The goal was to analyze these factors to highlight potential areas for improvement. Study Design. Case series with chart review. Setting. Tertiary care pediatric hospital. Subjects. Ninety-five inpatients at Boston Children’s Hospital requiring a primary or revision tracheostomy during the 24-month period encompassing 2010 to 2011. Methods. Inpatients undergoing tracheostomy during the study period were identified using 2 different databases: th