Respiratory care
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In the United States, care for COPD patients is frequently delivered by respiratory therapists (RTs). After implementing a therapist-driven protocol for COPD treatment, we sought to improve identification of COPD patients. We hypothesized that using an electronic medical record screening tool to identify subjects with COPD combined with a therapist-driven protocol would positively impact length of stay (LOS) and readmission rates. ⋯ Utilization of the electronic medical record to identify subjects with likely COPD combined with a therapist-driven protocol directed by RT assessment was associated with a trend toward decreased LOS and reduction in readmission rates. There was a significant reduction of respiratory-triggered rapid responses in subjects with a primary diagnosis of COPD.
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Thousands of children require mechanical ventilation each year. Although mechanical ventilation is lifesaving, it is also associated with adverse events if not properly managed. The systematic implementation of evidence-based practice through the use of guidelines and protocols has been shown to mitigate risk, yet variation in care remains prevalent. Advances in health-care technology provided the ability to stream data about mechanical ventilation and therapeutic response. Through these advances, a computer system was developed to enable the coupling of physiologic and ventilation data for real-time interpretation. Our aim was to assess the feasibility and utility of a newly developed patient categorization and scoring system to objectively measure compliance with standards of care. ⋯ We demonstrate the first patient categorization system utilizing a coordinated data-banking system and analytics to determine patient status and a surveillance of mechanical ventilation quality. Further research is needed to determine whether interventions such as visual display of variance from goal and patient categorization summaries can improve outcomes. (ClinicalTrials.gov registration NCT02184208.).
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Editorial Comment
Can Respiratory Therapists Impact COPD Readmissions and Costs?