The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

THE FISCAL IMPACT OF VARYING INTRADEPARTMENTAL COMMUNICATION METHODS

Russell E. Graham, Michael Berstein, Adrianne Gentry; Respiratory Care, Memorial Hermann - Texas Medical Center, Houston, TX

Background: Joint Commission(TJC) Patient Safety Goal NPSG.02.05.01 requires that a structured shift “handoff communication” occur. TJC Standard LD.03.04.01 further addresses effective communication within the institution. The Respiratory Care Department (RC) at our facility has > 100 FTE’s, and utilized a technique called “The 5 Minute Meeting”, occurring at the beginning of each shift. The goal was to disseminate pertinent departmental communications, and was in addition to regular shift report between therapists. Logistically, the plan called for a brief meeting and then moved directly to shift report. Over time, this format eroded into the “20 minute meeting”, wherein incoming staff would arrive late, and/or other extraneous factors would result in the meeting not starting (or ending) on time. Since individual report still needed to occur, end-of-shift overtime (EOSOT) began to increase due to the overlap. In addition, the lengthened report time became a staff dissatisfier, as the off going shift was delayed in departing the workplace. The amount of overtime was significant enough to warrant consideration for change, as well as the need to respond to staff satisfaction. Method: Retrospective review of payroll data. Results: EOSOT under the “5 Minute” plan accounted for 0.86 FTE’s. Using midpoint salary data, this EOSOT was costing the department budget in excess of $50000/Yr. After careful planning, the format was dropped entirely, focusing on shift report instead. The shift supervisor would serve as the medium for intradepartmental communication. EOSOT decreased to 0.54 FTE (a 37% decrease) and was maintained for a period of 90 days. While intradepartmental communication was continued, staff satisfaction remained a consideration. After review, a limited version of the original format called “News You Can Use” was reinstituted on a twice weekly basis (once for each shift). Discussion: EOSOT under this method has risen slightly to 0.66 FTE, but is still 0.20 FTE below the original format (a 23% decrease overall). Staff satisfaction has improved, and it is evident that a formalized group method for departmental communication be kept in place. While budgetary constraints remain a very real consideration, our experience exhibits that payroll savings can be recognized by careful consideration and implementation of method. Sponsored Research - None

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