The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

THE ROLE OF A SERVANT-LEADER MODEL FOR MANAGEMENT OF RESPIRATORY CARE DEPARTMENTS

K. Thigpen1, H. Derrick1, L. Simmons1, V. Vining1


Background: In todays' environment, our departments face pressure for cost-containment, recruitment & retention of qualified personnel, while maintaining quality care. In 2003, our department embraced a servant-leader model of management.

Method: Most employees were interviewed and an assessment made of likes, dislikes, obstacles and frustrations in their daily duties. We asked how we could make our department better. A complete reorganization of roles and responsibilities took place & positions filled based on talents, strengths and skill sets rather than tenure.
A core group was identified and from the information obtained from the staff, this group developed improvement pathways for most common threads. These included heavy workloads, frequent interruptions, and the inability to provide the level of care we desired.
A model was developed whereby team and shift leaders worked together to prepare workloads ahead of the shift, reduced interruptions for staff, & enabled them to perform one-on-one care at the bedside. In addition, we looked to improve care by introducing new time-saving technology to offset much of our workload. Many other staff suggestions were implemented.

Results: The following changes occurred after 20 months of review. Revision of charge process captured $315,134. Improvement in revenue capture, supply tracking resulted in identification of $205,603 in charges. "Save an hour" effort resulted in a $135,268 expense savings by voluntary reallocation of staffing. Our new weaning protocol led to a ventilator LOS reduction from 7.89 days to 2.8 days; a 5.09 day reduction per patient. As a result of the IHI ventilator-bundle, our VAP rate dropped by 52%. A Rapid Response Team was implemented as well as a clinical ladder and a program whereby our therapists were rewarded for their achievement of specialty credentials, over 100 of which have now been earned. Staffing has gone from 6 vacant positions in 2003 - 15% turnover rate to 0 vacancies and a 1.6% turnover rate as of December, 2006.

Conclusions: By embracing a servant-leader model for management, our hospital has successfully reduced costs and turnover, improved employee morale, and improved the levels of patient care and satisfaction. The vast majority of issues in our departments today can be solved with the input of the people involved in the process and by leaders taking an active role to implement meaningful change.

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