The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

TOTAL PATIENT CARE: RE-ENGINEERING FOR QUALITY PHASE I.

Rikki S. Bruinsma, Sharon E. Downey, Patricia A. Falco, Karen W. Hampton, Stephanie R. Holeton, Anthony B. Janik, Vickie S. McNair, James J. Reagan, Richard R. Rendell, Sonia R. Rivera, Susan R. Rockhill, Linda M. Smitherman, Brandon A. Thompson; Respiratory Services, Mayo Clinic, Jacksonville, FL

Background: As part of an enterprise-wide Staffing to Workload initiative, Respiratory Services at Mayo Clinic in Florida restructured and redefined the role of the respiratory therapist. Our mission, to achieve clinical excellence by streamlining and utilizing our skills to improve patient safety, patient and staff satisfaction, and continuity of care; to increase productivity; and to be better aligned with other Mayo Clinic practices, provided us with the impetus to embark on a journey that would transform the way we practiced. Method: Using Six Sigma and DMAIC methodologies, a team of managers and staff met over the course of seven months to develop and implement the Total Patient Care (TPC) model. Two early-on small tests of change quickly resulted in the decreasing of the number of per shift-required patient-ventilator assessments and eliminating the redundancy of checking continuous pulse oximeters on a certain patient population. Mandatory classroom and online education provided opportunities for all therapists to become trained and proficient in performing patient driven protocol assessments. Surveying the therapists, patients, and providers/nurses before the project provided important feedback used to increase customer satisfaction. Post project surveys were used to validate our successes. Results: Through implementation of the TPC model, we were able to improve staffing ratios by decreasing redundancy of tasks performed and streamlining our staffing model; improve customer satisfaction by decreasing the number of patient interruptions and better identification of the assigned therapist; increase job satisfaction through better utilization of skills; improve capture of charges by decreasing redundancies and potentially missed charges; and implement a system that better aligns staffing ratios by using nationally recognized time-standard allotments. Conclusion: The TPC initiative has allowed us to remove non-value added procedures from our daily task lists. Additional time gained in the work day now allows our therapists opportunities to spend more time with our patients, thus improving patient safety and providing more efficient and better quality care. The team will now regroup and focus on implementing Phase II of the project, which will provide our therapists with opportunities to perform more critical tasks, such as arterial line placements, intubations, and extracorporeal membrane oxygenation (ECMO) responsibilities. Sponsored Research - None