Tracheostomy-related incidents accounted for up to half of all airway-related deaths and hypoxic brain damage in intensive care settings. Multidisciplinary adult and pediatric tracheostomy teams have achieved dramatic reductions in adverse events and improved patient outcomes, but dissemination of highly reliable practices has lagged. In addition, new challenges and opportunities have arisen in the wake of the COVID-19 pandemic. These involve laryngotracheal stenosis, delays in follow-up care or decannulation, and widespread utilization of virtual care. This panel addresses knowledge gaps in this new era of tracheostomy care, providing strategies for rapid performance improvement and building blocks for enhancing care. Five key drivers- multidisciplinary ward rounds, standardized protocols, interdisciplinary education and staff allocation, patient and family involvement, and using data to drive improvement – can result in transformative change. We present data across institutions, providing turn-key solutions and lessons learned. We cover care from the index procedure to decannulation and discharge, discussing obstacles encountered and how they are overcome. Alongside institution-level experience, we report the largest structured tracheostomy practice improvement project to date, reflecting prospectively captured data from over 11,000 cases. We report multicenter efforts involving mixed method analysis, data tracking, and benchmarking to demonstrate statistically significant effects on reducing hospital and ICU length of stay, ventilator duration, and time to cuff deflation, oral intake, and first vocalization with dramatic cost savings. Collectively, these data provide a direction forward for multidisciplinary care amid the evolving landscape shaped by pandemic.