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Review ArticleReview

Implementing Change in Respiratory Care

James K Stoller
Respiratory Care June 2010, 55 (6) 749-757;
James K Stoller
Department of Pulmonary, Allergy, and Critical Care Medicine, Respiratory Institute, the Cleveland Clinic
Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.
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    Fig. 1.

    The Amicus model for change, by Silversin and Kornacki. This model of change is based on the foundations of leadership, shared vision, and culture and compact. The levers define specific steps that will encourage change to take hold. (From Reference 6, with permission.)

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    Fig. 2.

    As described in the text, this model outlines the process by which an individual can effect personal change. It starts by understanding one's “real self” (as you are), and then envisioning the “ideal self” (as you would like to be). Gaps between the real self and the ideal self are then clarified, which prompts development of a learning agenda and a personal development plan to close the gaps between the real self and the ideal self. The process is reinforced by risk-taking, experimentation, and an explicit plan to practice new behaviors and traits. (From Reference 8, with permission.)

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    Fig. 3.

    Structure and flow of a respiratory therapy consult at the Cleveland Clinic. The physician requests a respiratory therapy consult, which prompts an respiratory therapist (RT) evaluator to see and assess the patient, and, using branched logic algorithms, to develop a respiratory therapy care plan for that patient. The RT evaluator then either performs the needed therapy or calls an implementing RT to deliver the needed respiratory treatments. The respiratory therapy care plan is then reassessed, often at each shift meeting, in which the RTs question each other about the indications for the respiratory therapy the patient is receiving.

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Respiratory Care: 55 (6)
Respiratory Care
Vol. 55, Issue 6
1 Jun 2010
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Implementing Change in Respiratory Care
James K Stoller
Respiratory Care Jun 2010, 55 (6) 749-757;

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James K Stoller
Respiratory Care Jun 2010, 55 (6) 749-757;
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