Medical House Staff Impressions regarding the Impact of a Respiratory Therapy Consult Service

Abstract

Background

Although the Respiratory Therapy Consult Service (RTCS) has been shown to be effective in enhancing the allocation of respiratory care services, the criticism has been lodged that allocating algorithm-based decision-making to respiratory care practitioners detracts from physicians' in-training knowledge of respiratory care. To assess whether medical house staff regarded a well-established RTCS to be clinically and educationally helpful, we undertook a survey of house staff attitudes regarding the impact of this service on both patient care and house staff skill in ordering respiratory care.

Methods

A single-page, 6-question instrument was distributed at a regularly scheduled meeting of the Cleveland Clinic Foundation medical house staff. The questions posed were: (1) Do you know what the RTCS is? (2) Do you feel the RTCS is helpful or detrimental to the care of your patients? (3) Do you feel it has enhanced or detracted from your knowledge of respiratory care ordering? (4) Do you have a Respiratory Therapy Consult handbook? (5) Have you read it? (6) Have you found it helpful?

Results

Of a total of 95 available members of the medical house staff, 62 attended the meeting (65%), and 41 submitted responses (66% of attendees). Of the 41 respondents, 95% were aware of the RTCS. Similarly, 97% regarded the RTCS as being helpful to the care of their patients. Of 34 respondents, 56% felt that the RTCS enhanced the house staff's knowledge of respiratory care ordering, 32% felt that the Consult Service detracted from the house staff's knowledge, and 12% indicated that the RTCS had neither effect. Twenty-seven percent (11/41) indicated that they had an RTCS handbook, 19% (7/36) had read the handbook, and 33% (5/15) found it helpful.

Conclusions

We conclude that the majority of responding house staff at the Cleveland Clinic Foundation were aware of the RTCS, suggesting successful institutional notification about the service. Similarly, almost all house staff regarded the Consult Service as being helpful in caring for their patients (97%), while 56% felt that the Respiratory Therapy Consult Service enhanced the house staff's knowledge of respiratory care ordering. Further study is required to examine whether these impressions about the impact of the RTCS are supported by direct measure of the house staff's knowledge of respiratory care ordering.