1997 OPEN FORUM Abstracts
THE USE OF REAL TIME DATA TO JUSTIFY PRODUCTIVITY OF SPECIFIC PROCEDURES.
Susan Rinaldo-Gallo, RRT, MEd and Marcia Slaughter, RRT, Duke University Medical Center, Durham, North Carolina
Background: A consultant group was hired by Duke University Medical Center in 1994, to conduct an Operations Improvement (OI) study. One purpose of the OI study was to determine departmental productivity by reviewing time standards for all clinical procedures. Indirect patient care procedures such as travel time, documentation, patient care rounds, and report were also included during this process. All ancillary departments were evaluated during the study period. The OI study was finalized and the resultant measurement tool, utilizing these time standards, was implemented July 1, 1995. Respiratory Care managers were concerned with the results of the study and immediately began working with the Medical Center's Management Engineering (ME) Department to re-evaluate some of the OI findings. A Respiratory Care Information System (RCIS); CliniVision (CV) was implemented later that same month. The system is PC based, and allows for wireless communication between the department based PC network and bedside data entry by RCPs into handheld computers. Patient care data is entered on a "real time" basis; as the therapy is being delivered. Actual duration of each procedure is automatically calculated. Method: It was determined that time standards for the following high volume procedures would be re-evaluated: Intermittent Aerosol Therapy (IAT) and Metered Dose Inhaler (MDI). The actual duration for every IAT and MDI procedure performed for a four month period was sent from CV to ME. Following analysis of this data, a ME representative conducted observations (time studies) of these procedures being performed. The RCIS data and the observed time standards were used to calculate a Reasonable Expectancy Standard for IAT and MDI procedures. Results: The time standard for an IAT was increased by 2.35 minutes. The time standard for a MDI was increased by 1.2 minutes. This resulted in an increase in approved Full Time Equivalent (FTE) positions as shown on the chart below.
Previous New Time Per Cent Procedures Increased Increas-
Time Std Std Increase Performed Time ed FTEs
(min) (min) (hrs)
IAT 4.60 6.95 51.1 7,804 305.65 1.53
MDI 2.37 3.57 50.7 11,666 233.32 1.17
Total 6.97 10.52 19,470 537.97 2.7
Experience: This was our first experience in challenging the results of an outside consultant group. Without a departmental information system, this would have been much more difficult to do. Conclusion: The re-evaluation of time standards of two high volume procedures resulted in approval of an additional 2.7 full time equivalent RCP positions.