Optimizing Respiratory Therapy Resources by De-Implementing Low-Value Care.

Area of Science:

• Respiratory Therapy
• Healthcare Management
• De-implementation Science

Background:

• COVID-19 pandemic exacerbated respiratory therapy staffing shortages due to excessive workload.
• Identified limiting 3% hypertonic saline and/or N-acetylcysteine nebulizer therapies (3%HTS/NAC) as a key opportunity to reduce burden.

Discussion:

• A de-implementation policy empowered respiratory therapists to discontinue 3%HTS/NAC not meeting AARC guidelines.
• Physician and advanced practice practitioner education preceded policy implementation.
• Outcomes included monthly treatments, orders, and full-time employees for nebulized 3%HTS/NAC.

Key Insights:

• Significant reduction in monthly 3%HTS/NAC treatments (3,565.2 to 547.5) and associated full-time employees (5.1 to 0.8).
• Monthly mean orders for 3%HTS/NAC also decreased significantly (370.0 to 93.8).
• Non-3%HTS/NAC treatments remained stable, indicating no impact on other essential therapies.

Outlook:

• Empowering respiratory therapists to enforce AARC guidelines can reduce low-value therapies.
• This approach effectively lowers healthcare costs and staffing requirements.
• Potential for broader application in optimizing respiratory care delivery and resource allocation.