The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Deneen LeBlanc, Don Pearman, Richard M. Ford; Respiratory Care, University of California San Diego Medical Center, San Diego, CA

Introduction: Productivity systems for respiratory practitioners require an accounting of the RCP workday and capturing key activities. The AARC Uniform Reporting Manual provides time standards that can be applied to counts of these activities in order to quantify the hours required. The AARC URM includes over 90 different activities with time standards; however it is not feasible to account for 100% of the different activities secondary to limitations or restrictions in many billing systems to capture non chargeable activities. Ventilator setting changes are included in the URM, however few departments are able to capture counts of this activity. We elected to determine the number of ventilator changes in a 24 hour period and determine the impact of the failure to capture these activities on productivity. Methods: Electronic ventilator flow sheets were reviewed on a daily basis over a 45 day period and the number of ventilator changes in primary parameters per patient day was recorded in a separate spreadsheet. Analysis was performed on the data to determine the average number of setting changes. The URM time standard of 9.12 minutes was applied to determine hours required per patient day. Results: 261 observations were made. The average number of ventilator changes was 2.71 per patient day. These activities accounted for 24.71 minutes of time for each patient day when the URM time standard is applied. Discussion: Considering we average 900 ventilator days per month, 24.71 minutes of time per patient day accounted for 370 hours of staff direct variable activity per month. While it may not be feasible to capture the number of ventilator setting adjustments performed, the number of these activities accounts for considerable RCP time and can be of value in the assessment of staffing needs. Department based productivity systems should account for time spent in setting adjustments in determining workload productivity targets. Managers should also consider this factor when benchmarking against centers that are capturing the actual number of ventilator changes in which they may be compared.
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