Impact of Paid Time Off Week Process Within a Respiratory Care Department

Abstract

Background: Burnout and staffing challenges are prevalent within the field of respiratory care (RC). Paid time off (PTO) is an employee benefit that respiratory therapists (RTs) must utilize to combat burnout. Most RC departments experience challenges in staffing safely while granting PTO, even with professional guidelines in place, such as the AARCs Safe and Effective Staffing Guide. Our RC department (91.06 FTEs, 260-bed pediatric hospital, Level 1 Trauma, Level IV NICU) experienced these challenges and was often unable to approve consecutive day PTO requests for RT associates with our current model (full-time RTs with block schedules all request PTO through the scheduling system at least 6 weeks before the scheduling posting). We aim to assess the impact of a PTO week program on approved PTO time for RTs in our department.

Methods: In an IRB-approved retrospective review, PTO data from Kronos Scheduler, vacation request submissions, and solicited staff feedback were reviewed from 1/1/2023 to 4/30/2024. In July 2023, a PTO week program was implemented, allowing RTs to request up to 36 consecutive hours from Sunday to Saturday, with limitations during blackout weeks. Requests were submitted using a vacation request form with a requested week and an alternate. Submissions were accepted from 10/1/23-10/31/23 for the 2024 year. A seniority schedule was developed using our current rotating holiday schedule groups, and requests within the group are reviewed based on seniority.

Results: 43% of (34 of 79) eligible RTs submitted PTO week requests. All requests were approved, and 94% (n = 32) received their first-week selection. Without changes in total FTE and vacancy, PTO hours increased from 2023 to 2024 (January to April) from 4,011 h to 5,198 h (29.6%), and requests for consecutive days off reduced from 107 to 42 requests in the same period (Figure 1). Staff reported ease of use for the program, less stress, and satisfaction, knowing that their PTO time is approved well in advance. Many who did not utilize the program are excited to utilize it in 2025.

Conclusions: While participation was lower secondary to a new process, implementing the PTO week program in our RC department supported increased PTO time in multiple ways. The proactive approach to vacation planning reduces complicated consecutive shift requests while allowing more time to manage and plan for staffing coverage. Further studies must be done on the relationship of PTO for RTs and staff well-being, burnout, and satisfaction.

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Figure 1: Details the PTO Hours taken by RTs from January through April 2023 and 2024 before and after the PTO week request process implementation.