The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

IMPLEMENTATION OF A PATIENT DRIVEN PROTOCOL IN THE ERA OF COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE)

Dana Stauffer, James Rudegeair; Respiratory Care, Penn State Hershey Medical Center, Hershey, PA

Background: The misallocation of respiratory care services has been a growing concern with the introduction of a Computerized Physician Order Entry (CPOE) system at the Penn State Hershey Medical Center, a 500 bed academic medical center. In 2007, we introduced a respiratory therapy (RT) Assess and Treat protocol on the general ward at the Penn State Hershey Medical Center. In November of 2007, a change in medical leadership allowed an introduction of the Assess and Treat protocol in the Heart and Vascular Intensive Care Unit (HVICU). The overall objective was to individualize patient care and improve the utilization of organizational resources in the face of automated order sets with prescribed respiratory therapy treatments. Method: We conducted a retrospective analysis of 43 patients prior to implementing the Assess and Treat protocol in the HVICU, compared to 43 patients over the course of seven months following implementation. The data collected included the number of patients started on bronchodilator and recruitment therapy, total hospital length of stay (LOS), respiratory charges, and labor expense. Results: The Assess and Treat protocol implemented in the HVICU resulted in an 11% decrease in total bronchodilators ordered during FY 2009 (delivered by Respiratory Therapists and Registered Nurses) adjusted for patient volume. Total patient charges decreased by $23,890, with a savings of 101 hours of RT labor realized. Length of stay (LOS) for patients of comparable diagnosis related groups (DRG’s) decreased by 0.4 days; however, the results were inclusive (mean LOS 7.16, SD=3.24 pre Assess and Treat, post mean LOS 6.72, SD=2.85, t(84)=.672, p=0.5172). Conclusion: In the era of CPOE systems, a patient driven protocol is a viable option to improve the allocation of scarce organizational resources. Sponsored Research - None