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What is the responsibility of a Medical Director?
- Responsible for the clinical function of the department and provides oversight of the clinical care that is delivered.
- Medical direction for respiratory care is usually provided by a pulmonologist or an anesthesiologist
a medical director must possess both management and clinical skills
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What qualities should an RT have and where is knowledge obtained for an RT?
- The quality of a RTs depends primarily on their training, education, experience, and professionalism.
- Training teaches students to perform tasks at a competent level, whereas clinical education provides students with a knowledge base they can use in evaluating a situation and making appropriate decisions.
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To be eligible for credentialing, individuals must graduate from what?
CoARC-approved educational program
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Where can a person earn certification and take registry exams from?
offered by the National Board for Respiratory Care (NBRC)
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What help ensure that only qualified RTs participate in the practice of respiratory care?
Licensure and certification
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What are the additional skills required by an RT for implementing protocols?
- Assess and evaluate pt's regarding indications
- Cognizant of age-related issues
- Adapt hospital policies and procedures to alternate care sites
- Conduct and participate in research activities
- Communicate effectively with all members of the health care team
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What is a profession?
�a calling that requires specialized knowledge and often long and intensive academic preparation�.
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How do RTs demonstrate their professionalism?
by maintaining the highest practice standards, by engaging in ongoing learning, by conducting research to advance the quality of respiratory care, and by participating in organized activities through professional societies such as the AARC and associated state societies.
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What are the professional characterisitics of a Respiratory Therapist?
- Completes an accredited respiratory therapy program
- Obtains professional credentials
- Participates in continuing education activites
- Adheres to the code of ethics put forth by his or her institution and/or state licensing board
- Joins professional organizations
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Professionalism requires compliance with external standards, such as those set by what?
the TJC and by the government
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What is the purpose of HIPPA?
This act sets standards regarding the way sensitive health care information is communicated and revealed in the transmission of medical records and in the written and verbal communication of information in the hospital
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Who usually provides the technical direction of a department?
The manager of the department
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What is the responsibility of a manager?
They must make sure the equipment and the associated protocols and procedures have sufficient quality to ensure the safety, health, and welfare of the patient using the equipment
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Medical devices are regulated under what?
the Medical Device Amendment Act of 1976, which comes under the authority of the U.S. Food and Drug Administration (FDA).
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What is the key method used for enhancing quality respiratory care?
Respiratory Care Protocols
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How do respiratory care protocols enhance the quality of respiratory care services?
treatments and services that are indicated, delivered by the correct method, and discontinued when no longer needed
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What is a comprehensive approach for using protocols to combine specific protocols for a respiratory therapy?
respiratory therapy consult service or an evaluate-and-treat program
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What are methods used for monitoring the quality of respiratory care provided?
- Intrainstitutional monitoring practices
- Centralized, government monitoring bodies, such as TJC (The Joint Commission)
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In healthcare, no accrediting organization is more important than what?
The Joint Commission
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What does The Joint Commission do?
requires a hospital service to have a quality assurance plan to provide a system for controlling quality
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What is Continious Quality Improvement (CQI)?
- CQI is an ongoing process to detect and correct factors hindering the provision of quality and cost-effective health care.
- This process crosses department boundaries and follows the continuum of the patient�s care.
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What are specific methods to monitor the quality of respiratory care protocol programs?
- Conducting care plan audits in real time
- Ensuring practitioner training by using case study exercises
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How is a care plan audit performed?
With an auditing system, the auditor will write a care plan for a selected patient and compare it with the care plan written by the therapist evaluator to determine correctness
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How often should care plan audits be performed?
monthly, with results tabulated and reported monthly or quarterly, depending on the size of the hospital
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What are case study exercises?
- a computer-based system with which therapists can complete the assessments and care plans.
- The program scores the assessments and care plans and provides immediate feedback to the therapist.
- Individual therapists� performance data can then be added to a database to calculate and track aggregate performance statistics
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What is the responsibility of PROs (Peer Review Organization)?
evaluate the quality and appropriateness of care given to Medicare beneficiaries
Such PROs evaluate care provided to individual patients in real time to ensure compliance with federal guidelines
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What models have been most commonly implemented to carry out PRO (Peer Review Organization) health care improvement?
- Hospital restructuring and redesign
- Patient-focused care
- Disease management
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How is hospital restructuring and redesign achieved and what approaches are commonly used to do so?
- Flatten its hierarchies (i.e., reduce the number of management tiers)
- Decentralize some departments
- The ultimate goal is to attain greater organizational effectiveness and productivity while preserving or increasing employee satisfaction.
- Approaches for restructuring commonly include:
- Cross-training employees
- Using unlicensed assistive staff
- Decentralizing services by bringing them directly to the patient
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What model attempts to organize staff and services around the needs of the patient and bring specific services and resources directly to the bedside?
the patient-focused care model; and has largely declined in use
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What is descriptive of the following: The primary purpose is to provide therapy to patients needing and likely to benefit from therapy but to avoid delivering services to patients not likely to benefit?
Protocols
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What has been defined as a systematic population-based approach to identify persons at risk, intervene with specific programs of care, and measure clinical and other outcomes?
Disease Management
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What are the four essential components that comprise disease management programs?
- An integrated health care system that can provide coordinated care across the full range of patients� needs
- A comprehensive knowledge base, regarding the prevention, diagnosis, and treatment of disease, that guides the plan of care
- Sophisticated clinical and administrative information systems that can help assess patterns of clinical practice
- A commitment to CQI
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What is an approach to determining optimal clinical management based on several practices, and what are these practices?
Evidence-based Medicine
- A rigorous and systematic review of available evidence
- A critical analysis of available evidence to determine what management conclusions are most sound and applicable
- A disciplined approach to incorporating the literature with personal practice and experience
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