Abstract
Background: Respiratory care departments are experiencing an increased need to demonstrate value in the care they deliver. Value-efficiency is a concept that incorporates the value of individual treatments into the normal operations of a department. The purpose of this study is to describe and evaluate respiratory care leaders’ attitudes about value-efficiency.
Methods: An electronic survey was distributed via social media, professional networks, and a manager work group. The survey was targeted to directors, managers, and supervisors of respiratory care departments. We asked questions related to value efficiency. Data analysis was descriptive.
Results: We received 116 responses, 86% were from managers or directors. The five most valuable services delivered were conventional mechanical ventilation (82%), noninvasive ventilation or CPAP (71%), protocol-driven care (47%), code team (44%), and rapid response team (41%). The five least valuable services delivered by respiratory care departments were electrocardiograms (63%), stress testing (44%), lung expansion therapies (41%), sleep studies staffed by the respiratory care department (36%), and smoking cessation (36%). The primary barrier to value efficiency were physician prescribing practices (68%). There was general agreement (> 50% of respondents agreed) that physicians are supportive of RT protocols (71%), value should be considered when evaluating the effectiveness of respiratory care services (95%), and would you direct your resources to more valuable services if possible (73%). Respondents did not agree that hospital administrators understand RT workflow and FTE needs (35%) and hospital administrators would be supportive if we reduced services (18%).
Conclusions: There was limited consensus on what respiratory care services are the most and least valuable. Physician prescribing practice was the primary barrier to value efficiency. Nearly all respondents felt value should be considered when evaluating respiratory care services.
Footnotes
Commercial Relationships: Mr. Miller is a section editor for Respiratory Care and has received honorarium for lectures from Fisher and Paykel, consulting fees from MedEx Research and S2N Health, and gifts from Aerogen, and is a board member of the Carolina Virginias Chapters of the Society of Critical Care Medicine. Ms. Burr has received honorarium for lectures from ICON, ContinuED, and Vapotherm and is a member of the advisory board for Delaware Technical and Community College, Millersville University, West Chester University, Thomas Jefferson University, Rowan University, and the Delaware Chapter HOSA. Mr. Emberger has received honorarium for lectures from Draeger Medical and Avanos. Mr. Hinkson is the president of the American Associate for Respiratory Care. Ms. Hoerr is chair of the American Association for Respiratory Care Policy Taskforce, a member of the AARC Safe and Effective Staffing Guide committee, has received consulting fees from Missouri Health Professions Consortium, and is a member of the advisory board for Ozarks Technical College RT Program, St. Louis College of Health Careers RT Program, and the University of Missouri MHS Program. Mr. Roberts has received royalties from MedBridge Inc, receipt of equipment from CorVent Medical, and honoraria from the American Association for Respiratory Care and Society of Critical Care Medicine. Mr. Smith has received honorarium from Fisher and Paykel for lectures. Dr. Strickland has received research grants from the Centers for Disease Control and Council of Medical Specialty Societies and is a board member for the FACES Foundation and Accreditation Council for Education in Nutrition and Dietetics, and past president of Dallas-Fort Worth Association of Executives. Mr. Juby, Ms. Hoerr, and Dr. Rehder have no relationships to disclose.
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