Obstructive Lung Diseases |

Physician-Ordered Aerosol Therapy vs. Respiratory Therapist-Driven Aerosol Protocol: The Effect on Resource Utilization FREE TO VIEW

Avyakta Kallam*, MD; Kathy Meyerink, RRT; Ariel Modrykamie, MD
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Creighton University, Omaha, NE

Chest. 2012;142(4_MeetingAbstracts):656A. doi:10.1378/chest.1380620
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PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: The utilization of respiratory therapist-driven protocols is associated with improvements in resource utilization. Based on this, we started a quality improvement (QI) project to transition the delivery of respiratory care services from physician-ordered treatments to therapist-driven protocols. During the first phase of our QI project, we compared the frequency of bronchodilator administration, and its associated costs, between a physician-ordered bronchodilator strategy and a therapist-driven bronchodilator protocol strategy

METHODS: This was a retrospective analysis of data obtained during the initial phase of a QI project. Over a period of two weeks, respiratory therapists administered physician-ordered bronchodilator treatments and, simultaneously, they assessed patients’ severity levels and frequency of bronchodilator treatments that they would have administered if the protocol would have been followed. Forty-eight patients were ordered bronchodilator treatments, which resulted in eighty-eight assessments.

RESULTS: The utilization of a respiratory therapist-driven protocol would have resulted in 47.7% of all bronchodilator orders administered ‘every six hours, as needed’, and 30.6% of these orders administered ‘every eight hours’. Conversely, physician-ordered treatments were prescribed ‘every 4 hours’ in 63.6% of the cases. Total bronchodilator therapy cost in the physician-ordered group was $94,218.19, whereas it would have been $46,948.40 in the therapist-driven one. Per patient costs were $1070 (±262) in the physician-ordered, and it would have been $978 (±649) in the therapist-driven bronchodilator protocol group (p = 0.24).

CONCLUSIONS: The applications of a therapist-driven bronchodilator protocol can reduce the frequency of bronchodilator treatments compared with a physician-ordered treatment strategy. Costs of bronchodilator treatments, mostly the ones associated with respiratory therapist charges, may be reduced when therapist-driven protocols are utilized.

CLINICAL IMPLICATIONS: Utilization of therapist-driven bronchodilator protocols may reduce health-care costs.

DISCLOSURE: The following authors have nothing to disclose: Avyakta Kallam, Kathy Meyerink, Ariel Modrykamie

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Creighton University, Omaha, NE




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