THE COST OF TRAINING NEW RESPIRATORY THERAPY PERSONNEL
James K. Stoller, MD, Lucy Kester, MBA, RRT, FAARC, Douglas Orens, MBA, RRT, Cleveland Clinic Foundation, Cleveland, Ohio
Background: Retention of Respiratory Care Practitioners (RCPs) is a desired institutional goal that reflects department loyalty and RCPs' satisfaction. Cost considerations also favor retention because training new employees incurs costs. Despite the widely shared goal of minimal turnover, neither the annual rate nor the associated expense of turnover for RCPs has been described. Study Purpose: To establish the rate of RCP turnover and the costs related to training new staff members.
Methods: The Cleveland Clinic Health System (CCHS) includes 9 participating hospitals (in Cleveland, Ohio) ranging from small community-based institutions to large tertiary care institutions. To elicit information about annual turnover among RCPs throughout the CCHS, we conducted a survey of key personnel in each of the Cleveland CCHS Respiratory Therapy Departments. To calculate the costs of training, we reviewed the training schedule for an RCP joining the Respiratory Therapy Section at the Cleveland Clinic Hospital. Cost estimates reflect the duration of training by various supervisory RCPs, their respective wages (including benefit costs), and educational materials used in training.
Results: Table 1 presents the rate of RCP turnover (excluding PRN staff) by participating hospital. Table 2 presents the cost of training for each RCP at the Cleveland Clinic Foundation (CCF).
| Table 1: Respiratory Care Practitioner Turnover Rates Over The Past 3 Years |
| Hospital | Number of Beds | Number of RCP Staff | Annual Turnover Rate Averaged Over 3 Years | Average Number of Staff Leaving Per Year |
| Lutheran | 204 | 12 | 3% | 0.3 |
| Marymount | 279 | 32 | NA | NA |
| Hillcrest | 360 | 34 | 3% | 1.3 |
| South Pointe | 364 | 22 | 10% | 2.3 |
| Euclid | 371 | 20 | 15% | 3.0 |
| Huron Road | 379 | 13 | 18% | 2.3 |
| Lakewood | 400 | 23 | 9% | 2.0 |
| Fairview | 478 | 35 | 5% | 1.7 |
| Cleveland Clinic | 1192 | 96 | 9% | 8.2 |
| Table 2: CCF Costs Associated With New RCP Orientation |
| Day | Activity | Personnel | Wages $ |
| 1 | General hospital orientation | New orient | $188.48 |
| 2 | Hospital tour & Section policies | Orient, Supervisor, Education Coordinator | $431.04 |
| 3 | CliniVision training | Orient & Ed. Coordinator | $431.04 |
| 4-8 | Training with an RCP | Orient's wages x 1/3 RCP's wages x 5 | $1,523.39 |
| 9-11 | Orient takes 1/4 workload | 3/4 orient's wages x 3 | $424.08 |
| 12-14 | Orient takes 1/2 workload | 1/2 orient's wages x 3 |