Enhancing the Science and Practice of Respiratory Care Through

Academic Progression and Life-long Learning

Toni L. Rodriguez Ed.D, RRT FAARC2007-08 President of the AARC

Program Director Respiratory Care Gateway Community College, Phoenix AZ

Dr. H. Fred Helmholz Education Lecture Series

Conflict of Interest

I have no real or perceived conflict of interest that relates to this presentation. Any use of

brand names is not in any way meant to be an endorsement of a specific product, but to

merely illustrate a point of emphasis.

Objectives

Learning objectives for this presentation:

Objective 1 What defines a profession?Objective 2 Link lifelong learning to professional

developmentObjective 3 Benefits of the AARC Leadership

instituteObjective 4 Personal responsibility in professional

advancement

What Makes a Profession?

Profession

Work experiences range on a continuum from occupations to full fledged professions.

WORKERS

• JOB

PRACTITIONERS

•Emerging profession

Profession

al Practitioner

s

•Full Fledged Profession

Profession• Placement on the continuum is determined by

an occupation's degree of adherence to six basic features: autonomy commitment collegiality extensive education service orientation special skills and knowledge

(Dean,1979)

Profession

• How does one move from amateur to professional?– The professional role is more than what one

does; it is what one is!• Formal education• Socialization

Respiratory Care Profession

• What value is the profession of respiratory care to the health care team and society in general?

– Competence in a specialized body of knowledge and skill.

Professional Competence

• National Association for Medical Direction statement:

“ The hours of education and curriculum required for credentialing of a RCP should be the standard for all non-physician providers of respiratory care services”

Professional Competence

• 1994 report by Indiana University comparing respiratory and nursing curriculum.– Less than 2% of curriculum devoted to respiratory

therapy proceedures• Lewin Group, 1997

– Use of RCP’s is cost-efficient for services within their specialty area

Professional Competence

• Dr. James Stoller, 1998– RCP’s excel over nurses and physicians in

performing routine respiratory procedures.– Protocol based respiratory care reduce

misallocation of in-hospital respiratory care.

Professional Competence

• The Muse Study, 1999– Medicare beneficiaries treated by RCP’s had better

outcomes and lower costs than those not treated by RCP’s.

PURPOSE

• So why respiratory therapy?To fulfill a need for:

1. Advanced therapeutic knowledge of the physiology and pathology of respiratory disease2. Implementation and operation of complex medical equipment3. Monitoring critically ill patients and the highly complex

medical equipment around the clock.

PURPOSE

• Purpose: Called to provide patient advocacy in the area of maintaining and restoring normal function of the respiratory system.

Respiratory Therapists are the primary health care professionals with the education and training to facilitate patient care in the areas of oxygenation, ventilation and bronchial hygiene.

DRIVERS OF PROFESSIONAL GROWTH

You are living in the period of time that will produce more change for humanity than any previous era in history. It is a time of extraordinary importance that will fundamentally reshape almost every aspect of your life during the next two decades. Wholesale change is taking place in almost every segment of your reality-and the pace will only increase in the coming years.

John Peterson, The Road to 2015

External Drivers

• External Factors:– Changing demographics– Environmental issues– Socioeconomic factors– New and re-emerging infections– New Healthcare Reform Legislation– CMS Mandates

Internal Drivers

• Internal factors - paradigm shifts in health care:– Evidence based medicine replaces traditional

medicine – Consumer driven, patient centered healthcare – Prevention of disease with emphasis on healthy

aging

Internal Drivers

• Internal factors - paradigm shifts in health care:– Greater emphasis placed data related to the

quality of care provided.– Cross-training of non-physician healthcare workers – Shifts in reimbursement mechanisms inevitable.

Internal Drivers

In Change There is Opportunity!

“It’s not the strongest species that survive, nor the most intelligent, but the ones most responsive to change.”

Charles Darwin

BUT ONLY IF YOU ARE WILLING AND PREPARED TO TAKE

ADVANTAGE OF YOUR OPPORTUNITIES!

Sony engineers came up with the equivalent of the iPod long before Apple but internal culture focused on next generation of CD player

Kodak engineers invented the digital camera but saw it as a threat to their film culture.

Predicted Changes in Health Care• Acute care facilities more integrated while outpatient

facilities become focal of growth• New models of health-care delivery • Increased emphasis on coordination of care throughout

system• Continued Advances in Medical Technology• Evidence Based Medicine becomes the norm• Electronic Medical Records• Fewer Primary Physicians• Disease prevention• Disease management

CURRENT PRACTICE

FUTURE PRACTICE

CONTINUING EDUCATION

Lifelong Learning

• DefinitionLifelong learning is equipping yourself to deal with the new normal while maintaining your core values.

Toni Rodriguez

Continuing Education

• Prepares practitioners to function in the ever changing healthcare environment and to contribute to the further advancement of the profession.

• Provides a forum for the profession to examine its problems and identify appropriate solutions.

• Offers a setting in which the professional culture can be modified and developed.

It is not enough to anticipate our future role, competencies and skills. If our profession is unable to transition from where we are today to where we need to be tomorrow, we will fail.

Some Points to Ponder: Sam P. Giordano Respiratory care May 2011 Vol 56 No 5

FOSTERING A CULTURE OF LEADERSHIP AND LIFELONG LEARNING

AARC Leadership Institute: Fostering a culture of leadership.

Leadership is Everyone’s Responsibility

Leadership:• . . . is not a position• . . . is not about power• . . . is not about following someone • . . . is not about causing fear • . . . is not about giving orders

“Leadership is influence - nothing more, nothing less."

John Maxwell, 21 Irrefutable Laws of Leadership

Leadership Attributes x 360° AchievementLeader 360°

• If you don’t think of yourself as a leader, then you’re limited in your thinking. Leading is the way we help move people into action, including ourselves. The question is not whether you are a leader, but how WELL you lead.

• Bruce D. Schneider, Energy Leadership

Three essentials necessary to the success and longevity a profession:

Education: Links theory to practice in new and veteran practitioners.Management:: Facilitate fiscally responsible patient care that maximizes human and material resources to the betterment for the healthcare organization and staff.Research: The interpretation and derivation of the evidence that supports the efficacy and safety of the therapy we apply.

• Respiratory Care clinical experts may not possess the foundation knowledge to move into different positions in management education and/or research. •Promotion based upon excellent clinical skills does not necessarily translate into success outside of that role without foundation knowledge or skills.•Provides real-world education for RT’s with the desire to provide a foundation for career growth.

AARC Leadership Institute

Education Curriculum Competencies

• Principles & Methods of Respiratory Therapy Adult Education

• Developing Respiratory Therapy Courses and Evaluation of Learning

• Clinical Instruction Techniques for Students and Employees

• Classroom and Laboratory Instruction Techniques• Educational Technology• Continuing Education

Management Curriculum Competencies

• Health Care Infrastructure and Economics• Leadership and Your Organization• Leadership and Teambuilding• Integrated Business Topics for Managers• Law and Ethics: Practice and Application• Managing Human Capital• Finance and Budgeting for Departments• Data Driven Performance Improvement

Research Curriculum Competencies

• Ethics• The scientific method• Basic measurement theory• Identification of research topics • Review of the literature • Basic research designs • Steps in implementing a study • Basic statistical concepts • Publicizing study results

Benefits of the Leadership Institute: • Mentoring:

– Online classes that one completes at their own pace.– Backed up by specific communities on AARC Connect with faculty

serving as mentors• Contact with Module authors/subject experts • Contact with peers interested in the same topic• Participants can ask questions, engage in discussions, debate

important topics in an online discussion board• Build networks for future

AARC Leadership Institute

Institute Faculty• Institute Chairman:

Toni Rodriguez, EdD, RRT, FAARC• Track Chairs:

– Rob Chatburn, MHHS, RRT-NPS, FAARC (Research Chair)– Rick Ford, BS, RRT, FAARC (Management Chair)– Linda Van Scoder, EdD, RRT, FAARC (Education Chair)

Institute Faculty– Management Faculty:

• Cheryl A Hoerr, MBA, RRT, FAARC• Garry Kauffman MPA, RRT, FAARC• John Sabo MS, RRT, RN, FAARC• John Salyer MBA, RRT-NPS, FAARC• Shawna L. Strickland, PhD, RRT-NPS, FAARC

– Education Faculty:• Christine A. Hamilton DHSc, RRT, AE-C• Diane R. Oldfather MHEd, RRT• Toni Rodriguez, EdD, RRT, FAARC• Shawna L. Strickland, PhD, RRT-NPS, FAARC• Sarah M Varekojis PhD, RRT

– Research Faculty:• Robert L. Chatburn, MHHS, RRT-NPS, FAARC

Benefits of the Leadership Institute

• Format Presented as:– Web-based course– As PDF documents available for downloading– ePub download for your electronic reader– Complete at individual pace at time and location

best for you– Course materials, supplemental readings,

activities, quizzes

Benefits of the Leadership Institute

• End of course:– CEUs– Certificate of completion

Walking the Walk of Change

Culture

The sum total of the learned behavior of a group of people ..... and is transmitted from generation to generation

The collective programming of the mind that distinguishes the members of one group or category of people from another.

Culture

Culture is never rigid or stagnant but is constantly being shaped.

Culture

Key Question: Should the culture of our profession be shaped deliberately or accidentally by the

forces of the changing healthcare environment?

ACTUALPractice

As we are today.

REQUIRED Practice

What we need to be.

OptimumPractice

What we could be.

Our commitment to continuous learning is essential to the future health of our profession.

Continuing education

Continuing education

READY

Professional Evolution

RT Past:• Swartz tube, oxygen tent, BLB O2 mask, iron

lung• O2 technology• Setup and operation of basic equipment• Delivery of aerosol• Provide IPPB• Provide service/perform tasks

Professional Evolution

RT Present:• ICU vents• Non-invasive ventilation• ECMO• Transport of patients• Home care/Sub acute care• Aerosol delivery• Diagnostic studies• Disease management• Patient education• Consultants on patient care

Piedmont Technical College, Greenwood, SC

AARC Resources

• Summer Forum• International Congress• Web Cast Central ( over 100 offerings)• AARC Through the Journal• Guides and CPG’s• Exam Prep Course• Asthma-Educator/COPD Educator • Ethics Course

Position respiratory therapists in all healthcare settings:Medical Respiratory Therapist Access Act: HR

2619Target Unmet Patient NeedsBecome Gate Keepers for UtilizationPt. Support Across Spectrum of Care

Academic Progression

• Accreditation organization, credentialing bodies and licensing agencies validate mechanisms of academic progression.– Relevant accreditation standards for entry level to

advanced-level respiratory programs.• Final draft of Proposed Accreditation Standards• Accreditation Standards for Advanced Practice

Programs in Respiratory Care• Accreditation Standards for Degree Advancement

Programs in Respiratory Care

OJT/Hospital Based TrainingCertificate of Completion

Vocational Training SchoolsCommunity Colleges2002 Associate degree

Advanced Degrees:BaccalaureateMastersDoctorate

Academic Progression

Academic Progression

– Credentialing bodies evaluate professional Competence:

• Credentialing Exams• Continuing Competency Program• Specialty Examinations

– Licensure Agencies• Gate keepers for who can practice in a state• Determine minimum CE to renew license

TAKE AIM

Conference 2 Spring 2009

“Competencies Needed by Graduate Respiratory Therapists in 2015 and Beyond”, RC May, 2010, Barnes, GaleKacmarek, Kageler, et al

“Competencies Needed….2015…”• 67 competencies in 7 major areas:

– Diagnostics– Disease Management– Evidence-based medicine and respiratory care

protocols– Patient assessment– Leadership– Emergency and Critical care– TherapeuticsR C, May, 2010 Barnes, Kacmarek, et al

LET’S FIRE!

Doing Means Learning and Learning Means Doing

Evidence Based MedicineNew modes of ventilationInvasive Diagnostic ProceduresProtocolsNon-invasive ventilationAerosol device matching

Doing Means Learning and Learning Means Doing

Disease management opportunities:AsthmaCOPDObstructive Sleep ApneaSmoking Cessation

Opportunities to play an interdisciplinary role Make the most of teachable moments Only 1% of 140,000 RT’s design/conduct research

• What keeps a health profession valuable to the health care team and society in general assuring longevity?– Sound judgment grounded in ethical thinking.– A common body of knowledge unique to their profession.– Ongoing research through critical inquiry and creative

synthesis.– Commitment to maintaining competence through

continuing education.– A commitment to patient advocacy.

Keys to Continuing Professional Evolution

We must keep our core ideologies tightly fixed while displaying a powerful desire for progress that enables us to change and adapt without compromising what sets us apart as a profession.

Don’t Think:

Because it is too hard we should not do itBecause there is opposition we should stopOf the cost to yourself but of the many who will benefit

Only we can devalue ourselves as a professionals. CAREA true professional is a person who works within their institution to achieve the goal of excellence in patient care, and tailors their tasks to realize that goal. KNOWIf we don't do that, we are in the business of taking orders, which is a much less valuable endeavor. DO

Rise to the Occasion

It is easy to point fingers at those we feel have failed to advance our profession in the right direction.

But how many people take advantage of their chance to influence what is happening around them, instead of just choosing to do what they were told?

Accept the Challenge

Greatness lies ahead if we are trueto our calling as patient advocates

BUTBut if we forget, lose integrity,

are hampered by; fearinconsistency, compromise and

incompetence we fail to fulfill ourpurpose.

Lifelong Learning is an Individual Responsibility

THE POWER OF ONE TO MAKE A DIFFERENCE:

FOR BETTER OR WORSE

TAKE PERSONAL ACTION!

ACT I ON

RODRIGUEZ@GATEWAYCC.EDU