Bronchodilator Reform: Part II February 25, 2009
Posted by keepbreathing in Uncategorized.trackback
Today we have Part II of Freadom’s guest-posted series on Bronchodilator Reform. Why not head over to the RT Cave and thank him for these awesome posts?
Bronchodilator Reform (part II)
So we are in a healthcare crisis caused mainly by skyrocketing healthcare costs. Perhaps one of the culprits of this crisis is something RTs have been vying against for years — bronchodilator abuse. Shockingly, few have listened to our cries for reform. Perhaps, however, money will talk.
While important officials often go to hospitals looking for procedures and therapies that are no longer needed in order to save money, never do they set their beedy eyes on the respiratory therapy department where millions of dollars are wasted every year on frivolous treatments.
While Ventolin breathing treatments may not be the only cause of rising healthcare costs, they are a major contributing factor. In a pithy manner I will explain.
By now you know Ventolin is ordered by many doctors for all annoying lung sounds, and many patients who are short of breath regardless of the cause. That is what they do despite the fact Ventolin is ONLY indicated for shortness of breath due to bronchospasm.
Now you might be asking: what do useless breathing treatments have to do with the healthcare crisis. Well, consider the following.
Where I work treatments cost $84 a pop. I estimate (on the conservative side) that 80% of Ventolin
treatments ordered are not indicated and thus are non-beneficial to the patient. You can see, Houston, that we have a problem.
You do the math. Say the average hospital gives 40 breathing treatments during one 12 hour shift. That’s a total daily profit just from Ventolin treatments of $3,360. So you can be certain here we will not have hospital adminstrators on our side in our battle for bronchodilator reform.
But, when you consider who is paying the cost, officials might want to be aware that (80% of $3,360) $2,688 each day is going to this one non-indicated procedure. Multiply that by 365 and you gett $981, 820 wasted on Ventolin Abuse at just one hospital.
Multiply that by all the rest of the hospitals in the U.S. and that’s a lot of wasted money. Plus, mind you, I’m being conservative. The actual amount of money wasted on Ventolin therapies is more likely much higher.
Yet, still, when important officials go to hospitals demanding cuts in un-needed procedures, rarely ever do beedy eyes peer into the RT department.
Thanks again, Freadom!
While I hate to be the one to say, I love my job. I love paying my bills on the frivolous, unwarranted ventolin treatments that are given, There are many hospitals where RT depts are being fazed out. I worked in a small hospital. There was No RT’s there at night unless there was at least 3 vents running. In a larger hospital I worked at, it was the RT’s job to sign off that the RN had given the resp tx. The hospital was staffed only for ICU therapists and Code teams. If by doing what you propose, cutting out all of the treatments that Doctors give just because they want, They say they hear a wheeze, rhonchi, rales, or whatever. I would hate to predict that with cost cutting that RT departments would be the first to go. Just a thought….
Love your blog. My wife a non RT turned me on to you. I must strongly disagree with Just an RT. We need to eliminate some of the frivolous Txs we do. Then maybe we could more adequately care for the same patients. We would do better assesments, be more focused on our plan of care, decrease hospital stay lengths, and free up more beds for more people. We may decrease the amount of RTs, but I daresay we would improve the quality of RTs who stay. Where I work, we are always looking for good people. We propably need about 4 today. I also worked a few years ago in a small town where the same Rts worked in all 3 hospitals. I do believe you youngsters have a great future in this field if you could weed out some of the dinosaurs.
let’s just buy stock in the Ventolin company
In The hospital that I work at currently we are always understaffed as it is, we are called to do treatments because an RN believes that CHF can be cured with a breathing treatment. As an RT we are here to EDUCATE. Per JAHCO regulations we are to flag charts every 3 days to have treatments re-evaluated. I bypass this and call doctors because it is my belief that doctors too easily will just ignore what is written and say continue. But if you explain that a patient has had no pulmonary history, has had clear breath sounds and has a clear CXR then they tend to listen. This gets rid of frivolous treatments. it also educates the doctor what is expected by our department. Like I said before I love to pay my bills. There will always be doctors that order treatments that are not indicated. Where I work we work with the doctors in a group effort to care for our patients in a shared governance, we do a multi-disciplinary group for rounding on all patients in the ICU’s this includes Doctors, Pharmacy, Nutritionist, RT, NP discharge planner, We are all involved in the care of the patients. As a group we see what is working and what is not working, Unfortunately you will not be able to change the way some doctors think, or how they write orders, But we are lucky in our hospital we have protocols that eliminate that kind of wasted man-power. So at this point I am not sure if you are calling me a youngster or if you are saying that I am one of the dinosaurs that needs to be weeded out. In which case I am on the side of the patient. I am a patient advocate.