New Presentation Identifies Barriers to Protocol Implementation

June 21, 2008

Respiratory care protocols are a great way to improve patient care and reduce unnecessary expenditures at the same time. But implementing these tools in the typical department is often fraught with difficulty.

Two new surveys conducted by the Association’s Protocol Implementation Committee are helping to define the issue. “The AARC felt there could be more utilization of protocols by therapists and were unsure of what the barriers were,” explains Emily L. Zyla, BS, RRT, current chair of the committee. “We surveyed both management and practitioners to see what each group felt their barriers were.”

The first survey was completed by about 450 managers; the second by around 1,700 RTs who identified themselves as “staff therapists” in the AARC membership records.

Brian K. Walsh, RRT-NPS, RPFT, FAARC, who served as committee chair when the surveys were carried out, says the AARC was concerned so many facilities weren’t using protocols, even though they’ve been shown to help provide better care. Even more perplexing was why those that were using protocols were often only applying them to a minority of their patients.

“This seemed backwards to us,” says Walsh. “The AARC wanted to develop a marketing plan to give respiratory therapists and physicians the tools and knowledge to implement protocols. However, the barriers to this implementation were not clear.”

The surveys help to answer many of the questions about why protocols haven’t taken off like they should, and the results are now available to the membership in a PowerPoint presentation that everyone should view to get a better handle on what needs to be done to overcome the problem.

A key finding from the managers survey was the impression that staff therapists may not have the skills to function under protocols. Staff therapists, on the other hand, identified medical staff as the key barrier. Staff RTs also noted that they are willing to learn additional skills if adoption of protocols will assure their patients receive more appropriate care.

“The best way to convince a staff physician that protocols will work is to make sure they can trust the respiratory therapists to make them work. Respiratory therapists need to be seen as physician extenders who can provide the right care at the right time for the patient,” says Zyla.

“The corporate world has been providing ‘just in time delivery’ through seamless protocols for decades and now patient protocols allow us to do the same,” emphasizes Walsh, likening the situation to that which is used in clinical research on a daily basis.