The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

Data-Driven Restructuring: Using Information

Richard M. Ford, BS, RRT Sunday, November 3, 1996

The value of a Respiratory Care Management Information System (RCMIS) in times of cost containment and restructuring cannot be overstated. Cost effective management of respiratory services requires rapid identification and response to the changing patterns of care delivery needs in a concurrent rather than retrospective time frame. If it were not for the information system acquired in June of 93, the resulting access to data, and operational enhancements directly attributed to the RCMIS, the RC department at UCSD might no longer exist. The system at UCSD is PC based consisting of 2 workstations for data review, billing, report generation, and assignment of work, a database server and file server to manage and store information, and a communications server to facilitate the transfer of admitting, discharge and transfer (ADT) information from the hospital information system (HIS). Wireless communication between the department based PC network and the 16 point of care hand held computers communicate using spread spectrum radio frequency technology. At UCSD the radio frequency network is installed in an environment that consist of 11 floors, over 200 patient rooms, over a mile of corridors, with a respiratory care department located in the basement. Once installed, the system allowed us to demonstrate to the consultants and administration that the demand for respiratory services throughout the Medical Center has significant day to day, shift to shift, area to area, and inter-shift variability. In such an environment, it remains important to maintain the ability to vary labor resources and cross utilize staff to minimize idle time, maximize time spent with patients and maintain a productive workforce. We also demonstrated the abilities of RCMIS to automate the deployment of RCPs to work areas to match service demand through the work assignment capabilities. We demonstrated the utility of the RCMIS in providing data to drive, monitor, assess, and report results of the PDP program. The system proved to be the "enabler" of the PDP program. As the utilization of RC services decreased so to did the cost associated with providing such service. Since installation the benefits of RF have "paid-off". The RCMIS and the advantage of having RF played a key role in demonstrating the ability to provide cost efficient delivery of services at a time of organizational change. Today's RC managers have a much greater need for information. Systems must go beyond providing data on the volume of services, billing, or productivity. Systems themselves must improve operations, enhance resource allocation, and maximize RCP time at the bedside. At UCSD wireless point of care documentation plays a key role in a cost containment efforts directed at clinical resource management, allocation of resources, managing variability, and efficiency enhancements. WF Andrew, in discussing wireless point of care entry perhaps summed it up best: "If caregivers are to become effective managers of healthcare resources in a diverse clinical environment, they will need these tools to achieve efficient access to information to make well-informed decisions and to measure patient outcomes"

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