Exploring the Development of a Standardized Respiratory Care Language

Abstract

Background:

Standardized terminologies support unambiguous, concise descriptions of health problems and conditions to facilitate clear and consistent communication between caregivers, patients, and the public. The benefits of recording and maintaining indexed terminologies include: increased transparency regarding the association between interventions and outcomes, enhanced safety and quality of care through more effective clinical documentation, and demonstration of healthcare providers' value. It is apparent that there is an urgent need for a standardized language for the respiratory care profession. Our objective was to create a standardized terminology relevant to cardiopulmonary problems for which respiratory therapists provide diagnostic and therapeutic interventions.

Methods:

Practicing respiratory therapists and respiratory therapy students worked in small groups to develop a standardized terminology of frequently encountered problems specific to cardiopulmonary dysfunction guided by the grounded theory approach. Descriptive labels were sourced from discussions of clinical practice, experience in the clinical setting, respiratory care coursework, textbooks, peer-reviewed journals, and detailed content outlines for respiratory care licensing examinations. Each group developed a list of 20 patient problems encountered on a daily basis by respiratory therapists. Content validity of the descriptive labels and initial definition of each patient problem was assessed by expert respiratory therapists.

Results:

A fragment of a respiratory care domain ontology was generated from the finalized patient problem lists. Six categories and fourteen sub-categories of respiratory care patient problems were identified based on similarity of etiological characteristics.

Conclusions:

Standardized terminologies such as the Systematized Nomenclature of Medicine — Clinical Terms (SNOMED-CT) and the World Health Organization International Classification of Functioning Disability and Health (ICF) have improved many aspects of the healthcare process. Our work demonstrates that a respiratory care ontology can be created, validated, and expanded in the future to include additional patient problems. However, it would require testing in clinical applications before adoption and mapping to SNOMED-CT.