The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

JOURNEY TO EXCELLENCE: INCREASING PRODUCTIVITY WHILE ENHANCING EMPLOYEE SATISFACTION

By John A. Wolfe, RRT, CPFT and Edward Amend, BS, RRT

North Colorado Medical Center, Greeley, Colorado.

Background: Our Respiratory Care team was challenged by the ever-increasing need to accomplish more with less, and was frustrated by a lack of staff involvement in management decisions.  This was documented by an employee turnover rate of 14% and substandard employee satisfaction scores of 3.0 on a scale of 5.0. We wanted to find out if increasing staff involvement in patient care decisions would improve productivity, employee satisfaction scores, or both.

Method: A new director was hired in 2003, and was charged with developing a department focused on excellence.  An RT leadership council comprised of 8 staff members was assembled to improve staff engagement in departmental direction and goal setting. As a result of their consultative participation, we implemented an improved management structure, an employee recognition practice, a levalbuterol substitution protocol, and we revitalized an under-utilized respiratory consult service component. The levalbuterol substitution protocol ultimately reduced caseloads by switching patients from albuterol or (albuterol with ipratropium) Q4 and Q.I.D. treatment regimes to a Q8 levalbuterol regime with no increase in breakthrough requirements. The consult service broadened the RT's scope of practice by implementing the standard application of a structured system for writing a respiratory care plan that would optimize patient care.

Results: Although we experienced a steadily increasing census during the study period, the increased productivity afforded by the levalbuterol substitution protocol contributed to a decreased number of respiratory full time employees from 45.7 to 42.2. Pulmonary average length of stay (ALOS) was reduced from 4.4 to 4.0, reflecting an improvement in quality of care. Our employee turnover simultaneously plummeted from 14.2% to 6.7%, while employee satisfaction scores steadily improved from 3.0 to 4.5. The improvements were recognized in 2005 with an award for Best Respiratory Care Department by Advance for Respiratory Care magazine.

Conclusions: Increasing involvement by staff therapists in management goals can lead to increased productivity, improved patient care, decreased staff turnover, and enhanced employee satisfaction.



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