The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

AN ANALYSIS OF FEATURES OF CHANGE-AVID RESPIRATORY THERAPY DEPARTMENTS

J. Stoller1, R. Chatburn1, L. Kester1, D. Orens1, E. Hoisington1, M. Lemin1, M. Babic1, V. Roberts1, C. Dolgan1, H. B. Cohen1


Background: Although models of organizational change readiness have been developed, little attention has been given to determining features of change-avid (CA) health care institutions and, to our knowledge, none to features of CA respiratory therapy departments (RTDs). We undertook the current study to assess the features of RTDs that were characterized as being CA vs. not. Our specific hypothesis was that CA RTDs would score differently on change readiness surveys than non-CA RTDs; we also sought to identify specific characteristics that differentiate CA from non-CA RTDs.

Methods: The observations and scores were based on in-person interviews of the technical and/or medical director of 8 RTDs. Based on a priori criteria, 4 of the 8 hospital RTDs were deemed CA, i.e., satisfied > 2 of the following 3 criteria: 1. uses an RTD management information system, 2. uses a comprehensive RTD protocol program, 3. uses non-invasive ventilation for at least 20% of patients with acute exacerbations of COPD. Four other RTDs were deemed non-CA. Supervisors, organization development experts, and the medical director (MD) from our hospital (interviewers) recorded scores and impressions regarding practices and attitudes about change for the visiting RTD on 2 change-avidity scales: 1. adopted from Integrated Organizational Development, Inc., and 2. based on the 8-stage change model of John Kotter. Themes distinguishing CA vs. non-CA RTDs were identified by group discussion. Mean scores were compared with 2 way ANOVA with p<0.05 deemed statistically significant.

Results: Ratings for 4 CA RTDs differed significantly from 4 non-CA RTDs on both scales, suggesting that these change models apply to RTDs. While the final analysis of themes characterizing CA programs is still under way, preliminary findings suggest that CA RTDs use data to monitor activities and to suggest the need for change, enjoy good teamwork among RT leaders and staff, communicate with staff amply, have a committed MD, and value and practice reward and recognition.

Conclusions: In this first available study, change-avid RTDs can be quantitatively differentiated from non-CA RTDs. Specific features that especially distinguish CA RTDs include those stated in available change models. In the specific context of RT, assuring access to and analysis of data, practicing excellent teamwork among leaders and the RTD staff, and assuring ample communication are critical success factors.

Funding: Respironics, Inc.

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