The Science Journal of the American Association for Respiratory Care

1995 OPEN FORUM Abstracts

Improving The Utilization Of Cpt In A Pediatric Population

John W. Salyer BS, RRT, Karen kay Burton RN, RRT, Kathy Poll RRT. Primary Children's Medical Center, Salt Lake City, Utah.

Introduction: We speculated that Chest Physical Therapy (CPT) was being over utilized in our facility and thus sought to develop a program to optimize its use.

Methods: Guidelines for the use of CPT were developed collaboratively and approved by the hospital medical executive committee and appropriate faculty members at the school of medicine. RCP's were encouraged to use the guidelines to initiate a dialogue with medical and nursing staffs about optimal CPT utilization, but were directed not to refuse to do ordered therapy that appeared inappropriate. An extensive hospital wide training program was conducted with our staff and nursing staff. Every patient on CPT was assessed when the order was written, to see if this therapy was appropriate and the results of these assessments were tabulated. These data were analyzed with respect to the proportion of all CPT inappropriately ordered, or inappropriately administered, along with cost to administer this therapy. The appropriateness data were then reported to various nursing and medical services. The program was implemented in March of 1994. We used statistical process control techniques.

Results: We found that the proportion of all CPT orders that were inappropriate was [approx] 45% before the guidelines were implemented, and [approx] 40% after. However, after the guidelines were implemented, the % of inappropriate CPT actually administered dropped to [approx] 10%. There was a reduction in utilization of CPT of 52% when indexed to patient days, with a corresponding reduction in cost to administer this therapy of 66% or [approx] $73,000/year

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