The Science Journal of the American Association for Respiratory Care

2002 OPEN FORUM Abstracts

Respiratory Care Case Management: A Model Program

Fedrual Harrison, RRT, Chay Robinson, BS, RRT,
Louisa Quicho, BS, RRT, & Wayne Wallace, MBA, RRT
Kaiser Permanente Harbor City Medical Center, Harbor City, CA

BACKGROUND: Kaiser Permanente’s Harbor City Medical Center is an acute care hospital serving the HMO’s members in the Tri-Central Service Area. There is an out-patient case management program provided by RCPs, which serves primarily adult patients suffering from chronic lung disease.

Methods: The case management program monitors the patients’ control of their underlying chronic lung disease either telephonically or via home visits. Patient care plans are modified using a protocol or the patients are referred to their primary physician for further care or evaluation. All information pertaining to the patient visits/calls, care plan modifications, or physician referrals are maintained in a computerized relational database.

Results: A summary of the programÕs results over the past four years is presented in tabular form below:

Year
Productivity 1998 1999 2000 2001
Medication Change 246 329 406 383
Steroids Ordered 70 59 49 38
Antibiotics Ordered 34 44 50 28
Sputum Done 14 2 8 4
Trach Changes 21 13 12 14
Oxygen (initiated, DC, Æ) 142 107 146 280
Discharge Referrals 61 38 51 50
Provider Referrals 81 98 131 110
Referred to Other HCP 87 61 57 110
ABGs Drawn 1 3 2 1
Logged In Calls 1361 1425 1533 1395
Total # of Patients 226 305 310 397
Total # of Home Visits 733 864 977 1087
Ave # of Home Visits Per Day 4 5 5 5

EXPERIENCE: RCPs independently assess patients and have protocols to initiate/change/discontinue therapy.

Conclusions: A model program utilizing RCPs as case managers has demonstrated its long-term feasibility for this patient population.

OF-02-003

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