The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Daniel J. Grady, Terrence F. Smith, Lynda Collar; Respiratory Care, Mission Health System, Asheville, NC

Background: Various metrics have been utilized by proprietary consulting companies to determine Respiratory Care department staff resources, productivity, and comparative cost reduction "opportunities". Metrics such as Total Patient Days, Billable Procedures by CPT Code, Average Daily Census, and others have been utilized by consulting firms to determine the number of Respiratory Care staff needed in a department. However, the American Association for Respiratory Care Uniform Reporting Manual has recommended that Relative Value Units be utilized as the metric to accurately determine staff resources required for the safe provision of services. The purpose of this study was to compare correlations between AARC Relative Value Units and various metrics for a Respiratory Care Department in an 800 bed medical center. Methods: We retrospectively analyzed 30 months of hospital financial data for a sample of 835 (n = 835) days to compare RVU in hours with each of the following metrics: Total Respiratory Care Procedure Volume, Billable Procedures (by CPT codes), Non-Billable Procedures, Total Patient Days, Average Daily Census, Total Inpatient Days, and Adjusted Discharges per Patient Day (or Outpatient Procedures). Descriptive statistics, regression analysis, and Pearson's correlation coefficient (R 2) were calculated for each of the above metrics and compared to AARC Relative Value Units (RVU). Results: We found very poor correlations between RVU and the following metrics: Total Patient Days, Total Inpatient Days, Average Daily Census, Non-billable Procedures and Adjusted discharges per patient day . Weak correlations were found between RVU and Total Respiratory Care Procedure Volumes and between RVU and Billable Procedures with CPT Codes. Correlation data are summarized in the table below. Conclusions: In summary, metrics other than RVU did not correlate well, and do not accurately reflect Respiratory Care Department activity. Since none of these alternative metrics accurately reflect workload intensity; and metrics provide data to drive crucial decisions such as staffing levels, productivity, and comparative expense reporting between hospitals, it is recommended that Relative Value Units be adopted as the metric for Respiratory Care Departments. It is further recommended that Relative Value Units be adopted as the metric by state licensing boards to ensure that staffing levels are adequate for safe delivery of services.
Sponsored Research - None
Correlations Between Relative Value Units and Various Alternative Metrics