Respiratory Therapy Leaders' Perceptions of Value of Respiratory Care Services

Andrew G Miller; Katlyn L Burr; John S Emberger; Carl R Hinkson; Cheryl A Hoerr; Jerin Juby; Karsten J Roberts; Brian J Smith; Shawna L Strickland; Kyle J Rehder

doi:10.4187/respcare.12144

Respiratory Therapy Leaders' Perceptions of Value of Respiratory Care Services

Respir Care. 2024 Nov 19:respcare.12144. doi: 10.4187/respcare.12144. Online ahead of print.

Authors

Affiliations

¹ Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina; and Respiratory Care Services, Duke University Medical Center, Durham, North Carolina. Andrew.g.miller@duke.edu.
² Respiratory Care, Nemours Children's Health, Wilmington, Delaware.
³ ChristianaCare, Newark, Delaware.
⁴ Providence Regional Medical Center, Everett, Washington.
⁵ Respiratory Care, Phelps Health, Rolla, Missouri.
⁶ Thomas Jefferson University, Philadelphia, Pennsylvania.
⁷ Respiratory Care Services, University of California Davis Health, Sacramento, California.
⁸ American Epilepsy Society, Chicago, Illinois; and Rush University, Chicago, Illinois.
⁹ Division of Pediatric Critical Care Medicine, Duke University Medical Center, Durham, North Carolina.

PMID: 39562020
DOI: 10.4187/respcare.12144

Abstract

Background: Respiratory care departments are experiencing an increased need to demonstrate value in the care they deliver. Value efficiency is a concept that incorporates the value of individual treatments into the normal operations of a department. The purpose of this study was to describe respiratory care leaders' attitudes about the value of services provided by respiratory care departments.

Methods: An electronic survey was distributed via social media, professional networks, and a manager work group. The survey was targeted to directors, managers, and supervisors of respiratory care departments. We asked questions related to value, services, and barriers to implementation of value efficiency. Data analysis was descriptive.

Results: We received 116 responses; 86% were from managers or directors. The 5 most valuable services delivered were invasive mechanical ventilation (82%), noninvasive ventilation or CPAP (71%), protocol-driven care (47%), code team (44%), and rapid response team (41%). The 5 least valuable services delivered by respiratory care departments were electrocardiograms (63%), stress testing (44%), lung expansion therapies (41%), sleep studies staffed by the respiratory care department (36%), and smoking cessation education (36%). The primary barrier to value efficiency was physician prescribing practices (68%). There was general agreement that physicians support respiratory therapy protocols (71%), value should be considered when evaluating respiratory care services (95%), and directing resources to more valuable services if possible (73%). Respondents did not agree that hospital administrators understand respiratory therapy workflow and full-time equivalent needs (35%) nor that hospital administrators would be supportive if we reduced services (18%).

Conclusions: In a small sample of respiratory therapy leaders, there was limited consensus on what respiratory care services are the most and least valuable. Lack of consensus on high- and low-value services and physician prescribing practice were the primary barriers to value efficiency. Nearly all respondents felt value should be considered when evaluating respiratory care services.

Keywords: leadership; management value efficiency; respiratory care; respiratory therapist; respiratory therapy; value.