Egan Chapter 2: Quality and Evidence-Based Respiratory Care - PDF

Egan Chapter 2 Quality and Evidence- Based Respiratory Care Quality  Quality is defined as a characteristic reflecting a high degree of excellence, fineness, or grade.  Ruskin, a 19th Century British author stated “Quality is never an accident. It is always the result of intelligent ef...

Egan Chapter 2 Quality and Evidence- Based Respiratory Care Quality  Quality is defined as a characteristic reflecting a high degree of excellence, fineness, or grade.  Ruskin, a 19th Century British author stated “Quality is never an accident. It is always the result of intelligent effort” 2 Elements of a Quality Respiratory Care Department I. Medical Director  Responsible for the clinical function of the department  Usually is a pulmonologist or an anesthesiologist  Must possess both management and clinical skills 3 I. The Medical Director (cont.) 4 Quality Respiratory Care  It is essential that care is being provided as indicated and it is delivered competently and appropriately.  A Physician does not need to evaluate the patient in order to provide quality care due to Respiratory Therapy Protocols 5 Elements of a Quality Respiratory Care Department (cont.) II. Respiratory Therapists  The quality of a RT department depends on the education, experience, and professionalism of the therapists.  Training teaches students to perform a task at a competent level but Clinical education provides a solid knowledge base. You will develop those skills in clinic AFTER you have built that foundation in RCP100 and other courses.  Equipment also impacts the RT’s ability to provide the best care.  RTs are the primary source of the quality care provided by the department. 6 Elements of a Quality Respiratory Care Department (cont.) III. Credentialing in Respiratory Care.  Quality RC departments are staffed with RTs who hold appropriate credentials.  To be eligible for credentialing, individuals must graduate from CoARC-approved educational programs.  Graduates can then sit for the certification and registry exams offered by the National Board for Respiratory Care (NBRC).  CoARC committee is sponsored by four organizations:  AARC – American Association for Respiratory Care  ACCP – American College of Chest Physicians  ASA - American Society of Anesthesiologists  ATS – American Thoracic Society 7  The difference between credentialing and licensure Credentialing Licensure  General term that  The process in which refers to a government agency recognizing gives an individual someone in a permission to particular practice an occupation or occupation profession 8 Professionalism 9 IV. Technical Direction  Quality respiratory care depends on strong leadership.  The manager of the department usually provides the technical direction.  This person oversees the policies, procedures, and equipment used to provide safe and effective patient care. 10 Methods to Enhance Quality Respiratory Care Respiratory Care Protocols aka Therapist Driven Protocols  Put in place to enhance appropriate allocation of respiratory care services.  They represent guidelines to deliver care only when indicated, by the correct method, and discontinued when no longer needed. 11 Respiratory Care Protocols 12 Respiratory Care Protocols (cont.) 13  Monitoring Quality Respiratory Care  After all the elements are in place, quality respiratory care is maintained by monitoring.  One method to monitor the quality of care provided is to seek voluntary accreditation.  Accreditation by The Joint Commission is most important.  Current Joint Commission standards call for continuous quality improvement (CQI).  CQI is an ongoing process to detect and correct factors hindering quality care.  The AARC has developed four goals that should be included in the CQI plan. 14 Monitoring Quality Respiratory Care (cont.) Peer Review Organizations  The federal government has established an elaborate system of PROs to evaluate the quality of care given to Medicare beneficiaries.  Such PROs evaluate care provided to individual patients in real time to ensure compliance with federal guidelines. 15  Hospital Restructuring and Redesign  An attempt to do more patient care with less overhead  Common approaches include  Cross-training employees using unlicensed assistive staff  Training multi-skilled assistive personnel to perform basic patient care  Downsizing and decentralizing high-budget, labor-intensive units  Deploy RT’s to individual nursing units 16  Disease Management  Refers to an organized strategy of delivering care to a large group of individuals with chronic disease to improve outcomes and reduce costs  Disease Management Programs comprise of our essential components:  Integrated healthcare system that can provide coordinated care across the full range of patient’s needs  Comprehensive knowledge of prevention, diagnosis, and treatment  Clinical and administrative information systems that can help assess patterns of clinical practice  Commitment to continuous quality improvement  Disease management programs may be developed for patients with asthma, diabetes, COPD, or congestive heart failure 17  Evidence-Based Medicine  Represents an important concept regarding quality respiratory care  Refers to determining optimal clinical management based on evidence found in the scientific literature  The Clinical Practice Guidelines produced by the AARC represent recommendations based on a review of the evidence by experts. 18 Thank you for participating 19