Value Efficiency in Respiratory Care Departments

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 is to describe and evaluate respiratory care leaders’ attitudes about value-efficiency. 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 efficiency. Data analysis was descriptive. Results: We received 116 responses, 86% were from managers or directors. The five most valuable services delivered were conventional mechanical ventilation (82%), noninvasive ventilation or CPAP (71%), protocol-driven care (47%), code team (44%), and rapid response team (41%). The five 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 (36%). The primary barrier to value efficiency were physician prescribing practices (68%). There was general agreement (> 50% of respondents agreed) that physicians are supportive of RT protocols (71%), value should be considered when evaluating the effectiveness of respiratory care services (95%), and would you direct your resources to more valuable services if possible (73%). Respondents did not agree that hospital administrators understand RT workflow and FTE needs (35%) and hospital administrators would be supportive if we reduced services (18%). Conclusions: There was limited consensus on what respiratory care services are the most and least valuable. Physician prescribing practice was the primary barrier to value efficiency. Nearly all respondents felt value should be considered when evaluating respiratory care services.