Vol. 19 •Issue 22 • Page 12
Best Departments Honor the Past, Face the Future
“Excellence is to do a common thing in an uncommon way.”
–Booker T. Washington
For the 25th anniversary of Respiratory Care Week, which runs from Oct. 22-28, therapists are encouraged to look back at the profession’s growing tradition, to take a moment and recollect the contributions of pioneers and long-time leaders.
Think of those names that have become synonymous with textbooks and lectures. Their wisdom guides practitioners in facilities every day; their shadows loom large. Unspoken in these accomplishments is a challenge to sustain their legacy.
What RC week has come to mean at ADVANCE, however, is a chance to recognize the very best current departments, managers and practitioners who have earned top honors in our annual National Respiratory Care Awards Competition. In the contest’s sixth year, we continue to celebrate those who successfully rise to this occasion and carry forward the profession’s standard.
Winners and honorable mentions were selected by an independent panel of judges who reviewed nominations submitted earlier in the year. The essays offered a comprehensive view of the department or individual, everything from adopting innovative programs and technology to how the nominee goes above and beyond every day.
Selecting the créme de la créme was hard, and each entry proved that superior care is provided in hospitals both big and small across the nation. The profession’s founders would be proud to see that small towns and large cities enjoy the kind of dedication exemplified by these nominees. Top finishers received $1,000 and a plaque. Honorable mention winners, which are presented in no particular order, earned citations.
Our Best Department for 2006 contains some of the finest respiratory therapists in the nation. They exhibit intelligence, talent, a strong work ethic and commitment to the profession, all of the qualities every caregiver strives toward. Just one problem: they have no idea how good they are at providing all aspects of respiratory care.
That’s the chief reason nominator Sally Whitten, RRT, manager of respiratory care, was determined to bring Maine Medical Center’s (MMC) therapists national recognition. “The staff here is really crackerjack, and we’re proud of their work,” she said. “In terms of skill, knowledge, dedication and professionalism, I’d be willing to compare them to any respiratory care department. Occasionally, our therapists may not recognize just how skilled they are. I want them to know how much we value them.”
“I would echo that,” said Christopher Hirsch, MPH, RRT, director of pulmonary services. “Our practitioners are drawn to the critical care and academic environment offered at MMC that is usually only they have all that and the coast of Maine.” The pulmonary services department also includes The Maine Sleep Institute, which is fully staffed by RCPs.
MMC, a 606-bed facility located in Portland, Maine, is a premier referral hospital for northern New England. The Division of Pulmonary and Critical Care Medicine has five Pulmonary Fellows and is a key teaching site for two respiratory therapy schools in the region.
In the nomination, Whitten highlighted the facility’s many acheivements: progressive patient safety program, newly instituted clinical ladder and strong staff involvement.
RCPs serve and frequently chair multi-disciplinary efforts like the Rapid Response Team, Long Term Vent Rounds, VAP task force and Emergency Room Asthma Intervention Program. They are active in both the asthma educational program and with the asthma summer camp program.
Additionally the department sponsors the Paul Cox, MD, Memorial Conference (locally known as the Mud Season Conference), drawing attendees from across New England. Proceeds provide funding for staff to attend regional and national conferences at little or no personal cost.
MMC has earned a number of recent accolades, including Magnet Recognition for Excellence in Nursing and one of the 100 Most Wired Hospitals in 2006, fourth in the Consumer Reports “50 Exceptional U.S. Hospitals” list in 2005 and one of Solucient’s Top 100 U.S. Cardiovascular Hospitals in 2004.
During a roundtable interview, MMC staff were elated to have won the competition. “We feel so proud,” said Peggy Crowley, CRT, level I staff therapist. “It’s wonderful to receive this recognition.”
“It’s great! We never expected this,” said Sally Brewer, RRT-NPS, staff development specialist. “When there are so many open RT positions throughout the country, it says a lot that much of our staff has been here more than 10 years.”
For Faythe Henry, RRT-NPS, level III staff therapist, her approach to care is guided by the golden rule. “I go in every day doing the best I can, knowing I’d want my loved ones taken care of that way too,” she said.
At MMC, safe, family-centered patient care also means that the patient’s loved ones are allowed into the room during a code to see the efforts the staff is making on their behalf.
Carrie Smart, RRT, level II staff respiratory therapist, recalled a situation involving a failed resuscitation effort of a young patient where the family members were present. Following the extensive resuscitation effort, his mother thanked and hugged everyone in the room. “As difficult as the whole process was, that was a touching moment,” she said.
Patient safety remains one of the key initiatives, according to Jeff Brown, RRT, level II staff therapist. “We try to keep the workloads manageable, and the staff works together as a team,” he said. That may just be the key to their success.
Honorable mention winner–University Hospital in Augusta, Ga.–was nominated by Heidi Nelson, RRT, MHS, CPHQ, director of Performance Improvement and Respiratory Therapy. At the 551-bed community hospital, the motto is hire for attitude, train for skills.
“We want passion and drive. If you have a great attitude and if you’re a willing and able go-getter, you’re going to get ahead in the department,” she said. And happy employees translates to happy patients. The staff does not lose sight that excellent patient care is their mission, and feedback is done regularly so they are attuned to their performance level.”
Nelson is not shy about her ambitions to make University Hospital the best RT department to work at in the community and the state. “We are very fortunate that our recruitment and retention strategies have paid off; applicants often have to settle for a PRN position until a vacancy becomes available, and then we have a pool of staff to hire from; we know their skills, and they know our goals and systems,” she said. The word is out in the community: mediocre performers are not what the department is looking for.
The department has moved away from a task-driven mentality and now focuses on assessment, critical thinking skills and the importance of floor care. Nelson does not have an RT manager; instead she has four clinically strong team leaders, who have many years of experience. In addition, she believes in mentoring the next generation of team leaders and those who have excellent performance and have a desire for professional growth will have that opportunity to fill in as a team leader when needed.
They have made strides in terms of recruitment and retention by making sure students have a positive work experience, engaging front-line staff in decision making and establishing clear expectations.
“If you come to us with a problem, come to us with a solution. We create common goals for everyone to rally around,” Nelson explained. “We want to always have our therapists feel valued.”
Several RTs go to AARC Summer Forum and national meetings each year and determine what changes are needed. Then attendees come back, report on what things they learned and select promising ideas that can be implemented. Over 40 CEUs are also offered internally throughout the year.
Their efforts are gaining widespread attention. University was recently awarded the prestigious Magnet Designation by the American Nurses Credentialing Center. In addition to this honorable mention, the hospital’s respiratory therapy educator was selected as University’s Educator of the Year.
“Respiratory therapy has come into its own, and I am proud of our dedicated and talented team,” she concluded.
Make a Difference
At Saint Luke’s Northland Hospital in Kansas City, Mo., cross-training is the name of the game at this honorable mention facility. “Everyone does at least two or three other jobs, and I try to match people’s skills and interests,” said Mary Lou Guy, MBA, RRT, CHT, manager of Cardipulmonary and NeuroDiagnostics Services at the two-campus hospital. “We hold our staff to a high level of accountability, but all of the different departments help each other out.”
Beyond regular respiratory procedures, department therapists provide cardiology testing, PFTs, hyperbaric treatments, inpatient phlebotomy, EEGs, pulmonary clinic coverage, sleep and cath lab, bronchoscopies and special procedures coverage.
The department has used breath-actuated hand-held nebulization to deliver medication, which has allowed better medication delivery to the patient while reducing technician time required at the bedside. When possible, the department uses Xopenex at Q6 to reduce further the number of procedures done. This has also been a financial asset for the department, allowing the department to expand into other areas without increasing FTEs.
“We hire for our culture, so the people really want to work here. We make sure our needs fit theirs and theirs needs fit us,” said Guy, who completed an advanced degree last year. She reported that patient satisfaction for the department in 2005 averaged 96 percent with a peak of 98.5 percent.
“I am proud to be their manager,” she said. “I didn’t tell the staff I submitted the nomination, and they were so excited when they found out. Being selected as an honorable mention has made a big difference. I know they are highly respected in the hospital, but they don’t always realize it in the day-to-day work.”
As a part of a hospital of fewer than 100 beds, the department has grown dramatically in the past decade. The entire staff is dedicated to excellent patient care, the department and the hospital. Therapists willingly take on overtime to cover when someone is unable to come to work. They strive to make a real difference in the lives of their co-workers, patients and their families and the medical team.
“One of my long-term goals is to be recognized as the best department in the area and, hopefully, in the country,” said Guy. “We’ve got a ways to go, but I see no reason why a small department in Missouri can’t be the best.”
Shawn Proctor, associate editor and Web editor, can be reached at email@example.com.
Exemplify Best Qualities of Profession
Winners in the Best Manager Division of the sixth annual National Respiratory Achievement Awards Competition represent the best of what the field has to offer.
Let’s get to know them a little better.
At age 42, John Smith, BS, RRT, CPFT, has spent half his life in the respiratory field and a whopping 20 of those years in management.
Six months after graduation, Smith landed a job as night supervisor at a Pittsburgh hospital. “I was lucky to get that,” he said with a laugh. “Not many people want to work an 80-hour week of nights.”
Since then, he has moved on to slightly more humane hours and a far balmier climate. Smith now serves as clinical coordinator of respiratory care and pulmonary rehabilitation at Naples Community Hospital in Naples, Fla.
“He is an outstanding clinician, educator and communicator,” summed up Scott Wiley, MBA, RRT, director of cardiopulmonary services, in his nominating essay. “John is clearly a role model.”
Smith has diligently worked to empower fellow respiratory therapists and increase positive patient outcomes since joining Naples in March 2000.
The facility’s consult service, which he is largely responsible for implementing, allows RTs to automatically determine the most appropriate care plan for patients and to initiate the best possible therapy without delay.
In addition, he has helped the department redesign its medication delivery system so all drugs are stored in a locked cart. “We had carried the meds in our pockets like most folks have done for the longest time,” Smith explained. “Now, everything is secure.”
A computer located on the cart allows for bar code scanning and real-time charting so “99.9 percent of our documentation is online,” he boasts.
Numbers still need crunching, but Smith anticipates the new system will show shorter lengths of stays and better responses to therapy.
The dedicated RT further improves efficiency by focusing on staff education. He has developed an annual needs assessment survey to create a respiratory education calendar. The hospital provides a minimum of 14 free continuing education units for the staff during National Respiratory Care Week, as well as another 12 CEUs throughout the year. “They don’t have to go anywhere else to maintain their license,” Smith said.
He also challenges staff members on a monthly basis with lectures and quizzes and mentors them with one-on-one instruction.
Away from the office, Smith likes to spend his scant free time with his three daughters and wife, walking on the sunny Florida beaches and playing and coaching softball.
With the latter, his kids often vie for his attention and advice on the diamond, a trend that follows him back at work. Smith’s insights, work ethic and innovations make his contributions to Naples and the respiratory community at large invaluable.
“When John is not around,” Wiley wrote, “everyone knows it.”
A Florida Winner
Veteran staff members at Westside Regional Medical Center divide their careers into two distinct time periods: “Before Ted and after Ted,” wrote Penny Lawrence, RRT, in her nominating essay.
The much heralded “Ted” is Edward Alderman, BS, RRT-NPS, director of cardiopulmonary and neurodiagnostic services. And for more than four years, this honorable mention winner has played a key role in improving employee moral and working conditions at his Plantation, Fla., facility.
“We have more CEUs than we know what to do with,” joked Lawrence, manager of cardiopulmonary services.
Alderman, working together with other key staff members, helped develop and implement a ventilator-associated pneumonia protocol, a rapid response team and a program for respiratory therapists to deliver moderate sedation during bronchoscopies.
As a result of his efforts, the department has received Westside’s employee satisfaction award for the past two years.
“He is compassionate and hardworking and expects the same in return,” Lawrence said. “He has established a great rapport with everyone in the hospital, from patients to physicians to administration and everyone in between.”
A New York Winner
From his first day on the job back in December 1999, Herbert Hodge, BS, RRT-NPS, CPFT, another honorable mention winner, made it clear he intended to bolster people’s opinion of respiratory care.
“It is incumbent on everyone that is in a leadership role to uphold the mantle by doing all that we can to promote the profession,” said Hodge, the senior associate director of respiratory care at Generations+/Northern Manhattan Health Network of Bronx, N.Y.
“He is not afraid of taking on new challenges that most directors would avoid,” added colleague Mark Spence, BS, RRT, respiratory supervisor.
Hodge enacted several plans to achieve this goal, including:
Hodge encourages his staff to become certified in ACLS, PALS and RPFT and to pursue their bachelor’s degrees. When he joined the network, there were only a few registered therapists on staff. Now more than 90 percent hold that credential.
“He inherited a department that was an embarrassment to our profession and turned it into a gem,” Spence said. “Our department is now getting the recognition it deserves.”
Ohio Therapist Earns Top Practitioner Honor
Talent Plus Humility a Winning Combo
A dedicated healer, sympathetic communicator and formidable multitasker wins the nod to be named Best Practitioner in the 2006 ADVANCE National Respiratory Achievement Awards Competition.
To this long list of assets, Lynn Long, RRT, RCP, brings one more bonus: a decorous dash of humility.
“I’m really honored,” said Long, 43, team coordinator for the Respiratory Care Department at Marion General Hospital, in Marion, Ohio. “I know there are many really dedicated, knowledgeable therapists out there. Travis just makes it easy to be able to do my job well.”
Travis Grasley, MA, RRT, Long’s manager, did indeed wax effusive on his staffer’s talents and abilities. “Because of Lynn’s caring heart and high performance standards, her efforts have been recognized and praised by administration, co-workers and patients alike,” he wrote in his nominating materials.
He praised Long’s bedside manner, in which she manages to give therapy, chart it on a small laptop computer and educate, comfort and encourage her patient, almost at the same time.
“I think you can’t ever forget that patients are people,” Long told ADVANCE. “You can make someone’s hospital stay better by your attitude and how you respond to them.”
Two other therapists also merit praise as honorable mention winners in this year’s competition. They are George Chota, RRT, supervisor of Respiratory Therapy at San Juan Regional Medical Center in Farmington, N.M., and Ellen Mallery, RRT, therapist at Riverview Hospital in Noblesville, Ind.
Long’s career path began 16 years ago. She was a military wife living in Jacksonville, Fla., going for a BA degree in nursing. “We got the opportunity to move back home (to Ohio) but I couldn’t afford to enroll in the local nursing program,” she explained. Instead, she enrolled in the respiratory care program at Columbus State Community College—and has never looked back.
Asked what she likes about the profession, she said: “I enjoy critical care situations and the fact that we work so independently. It’s wonderful to assist someone to breathe better, be it a code or an asthma attack. Helping someone in such an obvious way is awesome.”
Besides her normal duties, Long serves as a member of a hospital task force that ensures all smoking patients receive smoking cessation education prior to discharge. Thanks to the task force, 98 percent of Marion General’s patients receive cessation counseling and about 40 percent remain nicotine-free at 90 days post-discharge, an impressive result for a wickedly difficult addiction.
Long said she’s ready to move up in the ranks of her department and take on administrative responsibilities, but she never wants to lose that direct contact with patients or other staff members.
Her advice to students and new therapists echoes her own work ethic. “Good communication skills are an absolute must,” Long said. “You must be able to prioritize your workload according to importance. You really have to understand the basics of respiratory care and have good critical thinking skills. Never think you know too much to learn or that you’re too old to learn. Always be open.”
Runners-Up Winners Too
Chota was nominated for several qualities, including stressing the importance of effective communication with patients, staff and other members of the care team. “George is a man with a smile on his face always,” Chota’s manager, Craig Johnson, BBA, RRT, told us. “This makes him the perfect mediator in major areasÉGeorge preaches communication to the staff all the time, and he lives it also.”
Chota has “set the standard for the department” by collecting all the relevant extracurricular certifications (NRP, PALS, BLS, ACLS). He also “routinely” presents informational classes at local high schools and community college nursing programs and organized a committee to develop a department protocol on ventilator weaning, Johnson said.
He called Chota “one of the most caring and concerned people I have worked with” in 16 years in the field.
Mallery’s strengths include versatility and education. “Ellen has helped develop an outstanding smoking cessation program in Hamilton County (Ind.),” RC director Nancy Collett, CRT, PSGT, reported. “She has six to 12 patients per class and gets more and more referrals each month.”
Mallery also plans a smoking cessation support group for recent quitters, has helped create a pediatric asthma clinic, and plans to establish an adult asthma clinic and a COPD clinic. In her spare time, besides her regular RC duties, she works in cardiopulmonary rehab, teaches new nurse orientation classes, helps out at health fairs and helps transport patients. Everything but make beds, you say? She does that, too.
“Ellen has received several ‘You’ve Been Caught’ awards from nursing staff and other respiratory staff for going out of her way to be helpful,” Collett explained. “She is dedicated, loyal, a team player, and willingly shares her knowledge with others.”