The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

STAFFING AND SERVICE MODEL CHANGES TO MEET INCREASED DEMANDS IN A LARGE TERTIARY CARE HOSPITAL.

Harry Morris; Respiratory Care, Adult Services, Florida Hospital, Orlando, FL

Background: For over 30 years, the Respiratory Care Department at Florida Hospital in Orlando had staffed Respiratory Therapists following a unit or floor-specific model. In some cases, there would be a Respiratory Therapist covering one floor alone.In recent times, as resources have become more scrutinized and service demand has increased due to the expansion of the physical plant in the opening of a new 15 story patient care tower, we were compelled to revise our service and staffing models. The new bed count is over 800 in the adult campus and consists of two patient towers as well as a sprawling horizontal complex. Method: This year we began modeling a Critical Care Consultation service concept. We have accomplished this in part by turning MDI/DPI treatments over to nursing in the acute care floors, while retaining the administration of nebulizer treatments thereby reducing the presence required on the general floors. In addition, we are currently divesting ourselves of non-core processes and atypical services that may be better delivered through other caregivers and we are also implementing a new staffing model. By dividing the adult hospital into 5 geographic zones with each zone tied logistically to a critical care unit, we are able to provide services to the vast far reaches of the hospital.The key element to the successful use of this model is continuous bi-directional communication. Assignment volumes change throughout the shift and if the lead or charge therapist is kept abreast of the dynamics, workloads can be adjusted appropriately. Results: Initially, there were concerns from the team that the ability to respond to STAT issues would be compromised. As it turned out, this was not the case. Our nursing colleagues on the general floors seem to feel more secure knowing that their patients needing a higher level of care are being tended to by Critical Care Respiratory Therapists. In a ddition, with zone assignments we are seeing a higher level of teamwork than in the past where everyone worked in silos. Conclusion: While Zone Staffing is a new concept for us, we believe it is the model that will allow us to meet the demands of a large urban tertiary center in the face of declining resources and increasing clinical demand. Our patients are receiving more accurate assessments of their needs and in many cases bypassing a trip to a Critical Care Unit. Sponsored Research - None