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.