A couple of years ago, an unexpected event led to an outage of air compressors in one of the buildings on the Thomas Jefferson University Hospitals campus in Philadelphia, PA. The immediate situation was addressed, but the incident helped to spur an initiative to reassess medical gas capacity at the facility.
Jerin Juby, MA, RRT, and his respiratory team played an integral role in coming up with solutions.
A joint effort
“The facilities department and respiratory care department worked closely with emergency management to develop plans to mitigate the risk of a planned or unplanned outage,” said Juby, who serves as the respiratory care manager at the hospital and an adjunct faculty member in the School of Continuing & Professional Studies at the university. “Respiratory therapists are experts in identifying and understanding the needs from a usage perspective.”
Because therapists use various devices with different levels of consumption, he believes they can add significant value to a team like this one through their ability to understand and predict what the system will have to handle and when it will have to handle it.
“The facilities department is the expert in mechanical systems,” he said. “Combining both brings an extraordinary team that can understand the system clearly.”
An action plan
The team began their analysis by looking at the issues involved in ensuring medical gas capacity in the hospital, identifying single points of failure, such as piping and power sources, and looking at the potential impact of the failure of any one system. Possible causes of the failures — power outages, floods, fires, natural catastrophes, and the like — were considered, as were the overall capacity of the system and backup capacity needs and plans for each system and location.
The team sought expert opinion from an outside consultant to help them address these issues and then took these steps to make sure the hospital would be ready for anything —
- Identified single points of failure for all systems and developed mitigation strategies to use during planned or unplanned outages.
- Evaluated the usage of medical air and oxygen for a 12-month period to understand the demand.
- Constructed oxygen and air manifold systems to support an outage during planned or unplanned outages.
- Purchased portable suction units to support an outage.
- Made the issue an ongoing priority with consistent team meetings.
Points of advice
Juby believes other RT managers can play a similar role in ensuring medical gas capacity in their hospitals.
“RT directors and managers should be aware of the mechanical systems that provide oxygen, air, and suction,” he said. “We are able to provide expert advice on the needs and should be an integral part of the discussions.”
He has these points of advice for his fellow managers —
- Connect with your facilities department to understand the current system if you are not already involved in these discussions.
- Collaborate with other high users like anesthesia and OR teams.
- Join the teams that discuss medical gas management or take the lead in putting together a team at your location that will constantly monitor these issues.
- Remember, every hospital system is different. You’re the expert in your system.
By taking an active role in helping their hospital address its medical gas capacity concerns, Juby and his RT team at Thomas Jefferson are helping to ensure patients will be well cared for in the event of an emergency.
The work has already paid off during the COVID-19 pandemic.
“These evaluations helped us have a good understanding of our capacity to run a high number of ventilators during COVID-19 surges,” he said.
It hasn’t hurt the department’s overall standing in the hospital either.
“RT involvement in projects like this definitely brings us to the forefront of health care,” Juby said. “Our participation in this project highlighted our expertise and brought out the value held by the department. It is also a reminder for us to explore areas that we have not.”
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