The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

Comparison of LTOT Oxygen-Conserving Devices: An Interdisciplinary Approach

Colin K. Drummond, Ph.D, Invacare Corporation,

E.R. McFadden, Jr., M.D., MetroHealth Medical Center

Background:  An informal survey of commercially available LTOT oxygen-conserving devices (i.e., intermittent oxygen profiles) revealed about 18 different devices with a bewildering array of reported savings ratios, conserving ratios, trigger pressures, actuation and cannula types.  An interdisciplinary approach to device clinical evaluation may more likely lead to standards ensuring optimal oxygen delivery for individual patients, reducing or eliminating device-specific titration.

Method: A research effort has been undertaken (bench-tests completed and preliminary clinical study completed) to compare and contrast the impact of standard steady flow oxygen delivery to that of commercially available oxygen-conserving devices. A unique interdisciplinary team (a large hospital working with industry) cooperatively worked over a 12-month period on (A) hypothesis formulation, (B) protocol development, and (C) stakeholder analysis.  Given fundamental differences in team members' background and training, a consensus process was undertaken to establish study direction and final recommendations.

Results: This study was launched as a preliminary study to gather data and team experience for larger investigations for device comparisons.  Here, we remark on process benefits associated with an interdisciplinary project approach: (A) interdisciplinary teams require individuals to frequently reach outside their "comfort zone" to understand discipline-specific terms, perspectives and protocol; (B) the highly iterative (time consuming) team process converged on a project definition each stakeholder was unlikely to have developed working independently, and  (C) incorporating devices from several different manufacturers into the study challenged industry to overcome and ignore device preferences, focusing instead on the greater industrial value of device standards potentially improving LTOT patient outcomes.

Conclusion: An interdisciplinary team approach challenges individual and organizational perspectives, but through a consensus process (versus individual dominance) mutually beneficial outcomes are achieved.

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