University of Michigan Health Systems
Validation of Work Processes for Pediatric Respiratory Care
Final Report
Clients:
Ron Dechert - Manager, Respiratory Care
Teresa Keppler - MSA, RRT, Clinical Information Analyst Sr., Respiratory Care
Renee Uchtorff - Respiratory Therapist Supervisor, Respiratory Care
Project Coordinators:
Samuel Clark - Senior Management Engineer, Program and Operations Analysis
Marianne Pilat - Lean Coach, Michigan Quality Systems
Professor:
Dr. Mark Van Oyen - IOE 481 Professor
December 10, 2013
Project Team 8 Members:
Dan Bracciano
Liang Deng
Mark Grum
Stephen Lee
Table of Contents
Executive Summary ...................................................................................................................... 2
Introduction ................................................................................................................................... 5
Background ................................................................................................................................... 5
Goals and Objectives ............................................................................................................. 5
Key Issues .............................................................................................................................. 6
Project Scope ......................................................................................................................... 6
Data Collection ............................................................................................................................. 6
Literature Research ................................................................................................................ 6
Staff Interviews ...................................................................................................................... 6
Shadowing.............................................................................................................................. 7
Beeper Study .......................................................................................................................... 7
Data Analysis ................................................................................................................................ 7
Shadowing ............................................................................................................................. 7
Beeper Study .......................................................................................................................... 8
Findings and Conclusions ............................................................................................................. 8
Shadowing.............................................................................................................................. 8
Beeper Study .......................................................................................................................... 10
Recommendations ......................................................................................................................... 10
Expected Impact............................................................................................................................ 11
Appendix ....................................................................................................................................... 12
1
EXECUTIVE SUMMARY
The Respiratory Care department moved from the Taubman Center to the C.S. Mott Children’s
Hospital in December 2011. The much larger facility has resulted in increased travel for
therapists and a more dispersed work area. Despite this, respiratory therapists are using the same
workload distribution. In addition, there is a current disparity between the current time standards
and those recently released by the American Association of Respiratory Care (AARC).
Specifically, the contact minutes are 252 minutes per 24 hours of service while the national
standard in the AARC are 157 minutes per 24 hours of service. This shows that respiratory
therapists are taking a longer time with patients to achieve similar results in the national
standards. To address the disparity with the national standards and account new facility factors,
Project Team 8 was tasked to validate the current workload and workflow.
Goals and Objectives
The primary goal of this project was to inform staffing decisions in the respiratory therapy
department by discovering how workflow affects workload and the balance between them. The
team achieved this through the following tasks:
 Conducted time studies of therapists to validate current time standards
 Determined the current mean time for separate therapy’s
 Determined current proportional division of therapists activities
Methodology
The team collected data through the following five separate methods:
Literature Research
The team reviewed reports written by previous IOE 481 teams who also worked with the
pediatric respiratory unit. Two similar reports on the pediatric respiratory unit in the fall of 2006
and the winter of 2007 were discovered and reviewed. These reports grouped care by whether it
was direct patient care or indirect which the team adopted in its analysis.
Staff Interviews
The team developed a list of interview questions, which were conducted with 16 pediatric
respiratory therapists. These interviews were not intended to be statistically relevant but were
intended to identify preliminary focus areas for the shadowing phase and help the better team
understand the workload of the respiratory therapists.
Shadowing
In the shadowing stage, the team followed pediatric respiratory therapists over the hours of 7 AM
- 11 PM for each day of the week. This spread of times was covered to ensure that the data
would not be biased based on high or low workload times. Over the course of 5 weeks, 89 hours
and 30 minutes were observed. The team worked with the clients to develop a compressive list of
activities to track as well as a tracking sheet format, which may viewed in Appendix A. The
grouping of concurrent activities was also determined to be a useful method for recording data
due to the teams limited observation capabilities and the fact that the A.A.R.C. time standards
are structured in a similar manner.
2
Beeper Study
During this stage, the team supplied the respiratory therapy staff with beepers, which randomly
alerted the staff at a mean vibration occurrence of two times per hour. Over the two weeks, on
both night and day shifts, 8 staff members were participating in the study at any given
time. Therefore, in total, data from 192 shifts were collected. The goal of this study was to
gather data, which would accurately show the proportional division of labor across units and
hours of the day.
Data Analysis
The data analysis was done for the shadowing stage and beeper study. Each analysis showed the
distribution for direct, indirect, and unscheduled activity, along with time values for each driver.
To properly structure the shadow data, the team developed a template in Excel, seen in Appendix
B, in order to ensure the data entry would allow for proper manipulation of the data. Pivot tables
were constructed in order to identify the mean times of major activities when they occurred with
and without concurrent activities. Microsoft Access was used in order to create queries to show
tables that included the main drivers and the concurrent activities, which went with them.
The team worked with the clients and coordinators to develop a methodology of data input for
the beeper study data, which would reflect the proportional division of labor across units and
hours of the day. This data was compiled based on the variable, which was being addressed,
producing proportional divisions based time of day, type of care, and other factors
Findings
Due to the fact that the team conducted two different types of time studies, which produced
different types of data, it is necessary to separate the findings from this data based on the
methodology, which was used to obtain it.
Shadowing
1575 activity were recorded throughout the shadowing period. While all records were
documented, the main activities, also known as the drivers, were furthered analyzed per the
clients’ request. Seen in Table 1 is a list of each driver, along with the number of occurrences,
total time in minutes, median time per number of occurrences, mean duration, and concurrent
activities for each driver. Concurrent activities for each driver are shown in Appendix W –
Appendix AB.
Table 1: Time Values and Distribution for Each Main Driver
3
Beeper study
In total, 3231 beeps were recorded across the four main units. Displayed in Figure 1 is the
proportional division of those beeps as marking direct patient care, indirect patient care, and
unscheduled activity.
Figure 1: Distribution of Reported Beeps in Different Units
As seen in the figure, higher levels of unscheduled activity were reported in the NICU and PICU
(11-12%) than were in the General Care floors and the PCTU (4-5%). In addition, a higher
proportion of direct care was reported as occurring in the General Care floors (59%) than were in
the three ICU units (47-53%).
Recommendations
Due to the lack of clinical expertise, Team 8 is not able to give recommendations to upper
management for Respiratory Care at C.S. Mott Hospital.
Expected Impact
As mentioned above, Team 8 lacks the clinical knowledge to make informed decisions about
how to change the care provided by respiratory therapists. However, the data that was collected
and analyzed by the group can be used by upper management for future work. With their clinical
background, upper management will be equipped to make decisions that affect workflow and
workload about pediatric respiratory therapists in C.S. Mott Hospital.
4
INTRODUCTION
In December 2011, many of the clinics that were located in the Taubman Center moved into its
own building, now called the C.S. Mott Children’s and Von Voigtlander Women’s Hospital. The
time standards used for procedures in the previous facility are still influencing staffing decisions,
even though the current facility is much larger. As a result, the Administrative Director of the
department of Respiratory Care in the C.S. Mott Hospital is concerned about the workload
distribution and workflow of the respiratory therapists. Using quantitative measures, Mott’s
upper management discovered that the current time standards do not match the national
standards of the American Association of Respiratory Care (AARC). By comparing this data to
the AARC, upper management is concerned because the workflow and workload is not as
productive and efficient as the national standards of the AARC. The time standards serve as a
specification for determining how many respiratory therapists are scheduled for each shift and
task. Subjective measures from both Mott’s upper management and respiratory therapists show
that respiratory therapists are forced to walk longer distances resulting in an increase in both
non-value added time and physical challenge of the respiratory therapists because of the larger
facility. As a result, the Administrative Director asked the Industrial and Operations Engineering
(IOE) 481 Project Team 8 at the University of Michigan to develop methods to update the
current time standards in order to take into account of the much larger building. The team’s task
was using the time standards to recommend how the workload and workflow of the Respiratory
Care department could be changed or updated.
BACKGROUND
The Respiratory Care department was moved to the current C.S. Mott Children’s Hospital and
Von Voigtlander Women’s Hospital in December 2011. The much larger facility results in
respiratory therapists walking on average 1.5 miles per 8-hour shift, which is much more than in
the previous facility. Even with the increase of space, the workload distribution that was
developed in 2005 is still being used. The upper management recognizes this as a potential issue
and reason why the current time standards, specifically contact minutes and full-time
equivalency (FTE), does not match the national standards of the AARC. The contact minutes are
the total time respiratory therapists are in direct contact with the patients. Therefore, this value
does not include walking, lunch breaks, etc. Currently, the contact minutes are 252 minutes per
24 hours of service while the national standard in the AARC is 157 minutes per 24 hours of
service. This shows that respiratory therapists are taking a longer time with patients to achieve
similar results in the national standards. The upper management also expressed concern with the
FTE. FTE is a standard unit to incorporate total working hours of part-time and full-time
respiratory therapists. Currently, the full-time equivalent (FTE) of respiratory therapists is 0.73
per 10,000 units, and the national standard is approximately 0.5 per 10,000 units. The evidence
shows that the Respiratory Care unit has an overall 55 percent inefficiency rate. To address this
issue, Project Team 8 was tasked to validate the current workload and workflow and develop
recommendations to improve efficiency. The workflow being the chronological order of key
tasks the respiratory therapists perform and the workload being how the different tasks are
distributed to the respiratory therapists working on a given shift.
Goals and Objectives
The primary goal of this project was to inform staffing decisions in the respiratory therapy
department by discovering how workflow affects workload and the balance between them. The
team achieved this through the following tasks:
5



Conducted time studies of therapists to validate current time standards
Determined the current mean time for separate therapy’s
Determined current proportional division of therapists activities
With the information, the team:
 Provided data on therapists’ workflow and workload distributions
 Showed proportion of direct care, indirect care and unscheduled activity
 Updated time standards of pediatric respiratory therapists
Key Issues
The following key issues drove the need for this project
 Respiratory Care department has moved to a larger facility; however, the time standards
from the old facility are still being used
 Scheduling system was regularly recommending more therapists than are recommended
by the AARC standards
 There were 252 contact minutes per 24 hours of service compared to 157 contact minutes
(AARC Standard)
Project Scope
This project addressed issues related to the distribution of workload and workflow of the
pediatric respiratory therapists and the development of new time standards for the Respiratory
Care department. It focused on work activity in units from 7th to 12th floor all days of the week.
This project did not include recommendations about how the pediatric respiratory therapists
provide their care. In addition, this project did not provide a new work schedule and assign
specific work to respiratory therapists.
DATA COLLECTION
The team collected data through the following five separate methods:
Literature Research
The team reviewed reports written by previous IOE 481 teams who also worked with the
pediatric respiratory unit. This was done in order to formulate the procedural structure of Team
8’s report. Two similar reports on the pediatric respiratory unit in the fall of 2006 [cite] and the
winter of 2007[cite] were discovered and reviewed. These reports conducted time studies of the
unit in its much smaller previous location. It was also discovered that these time studies are still
being used in the new facility. These reports grouped care by whether it was direct patient care
or indirect which the team adopted in its analysis.
Staff Interviews
The team developed a list of interview questions, which were conducted with 16 pediatric
respiratory therapists. These questions addressed topics such as the effects of the new facility on
their workday and what the therapists view as the greatest inefficiencies in their workplace.
These interviews were not intended to be statistically relevant but were intended to identify
preliminary focus areas for the shadowing phase and help the better team understand the
workload of the respiratory therapists.
6
Shadowing
In the shadowing stage, the team followed pediatric respiratory therapists for a series of fourhour blocks. These shadowing sessions were spread over the hours of 7 AM - 11 PM of each
day of the week. This spread of times was covered to ensure that the data would not be biased
based on high or low workload times. To meet this shadowing goal, each team member
shadowed for a minimum of four hours a week with one team member shadowing for 8 hours
each week. Over the course of 5 weeks, 89 hours and 30 minutes were observed. The team was
permitted to follow the therapists around for the entire duration of the shadowing shift but was
not permitted to enter patient rooms. Therefore, the clients and the team determined that, given
the teams observation limitations, data on concurrent activities should be grouped as one time
block. For example, if a therapist went into a room and performed an MDI for 10 minutes,
patient assessment for 5 minutes, and documentation for another 5 minutes, the team would
recorded that occurrence as an MDI for 20 minutes with patient assessment and
documentation. The grouping of concurrent activities was also determined to be a useful method
for recording data due to the fact that the AARC time standards are structured in a similar
manner. An example of the recording sheet with data may be viewed in Appendix A.
Beeper Study
During this stage, the team supplied the respiratory therapy staff with beepers, which randomly
alerted the staff at a mean vibration occurrence of two times per hour. Over the two weeks, on
both night and day shifts, 8 staff members were participating in the study at any given
time. Therefore, in total, data from 192 shifts were collected. In addition, the participating
therapists were evenly distributed amongst the PICU, NICU, PCTU and general care units. The
staff was also supplied with tracking sheets on which they would select their current activity
upon alert. In addition, these tracking sheets were separated by the hour of the shift. The goal of
this study was to gather data, which would accurately show case both the proportional division of
labor across units and hours of the day.
DATA ANALYSIS
Shadowing
To properly structure the data, the team developed a template seen in appendix B in order to
make sure the data entry would allow for proper manipulation of the data. The team worked
with the clients and coordinators to develop a methodology of data input, which would reflect the
grouping of data. As seen in the appendix, records consisted of date and time information, unit,
activity being performed, the start and stop times that activity, whether the care was direct or
indirect and scheduled or unscheduled. Also, all activities were assigned a record number and an
order number to allow for the pairing of activities, which occurred in the same time
block. Concurrent activity records, which occurred in the same time block were assigned the
same record number with their order numbers incrementing on the basis of most predominant
activity within the time block.
To analyze the shadowing data, the team looked at 5 factors for each driver the clients had
specified: Number of Occurrences, Total Time, Median Time, Mean Time and Concurrent
Activities. Appendix V shows these data for the desired drivers. To find the concurrent
activities for each driver, the team had to import the shadowing data into Microsoft Access. After
7
running queries on unique instances of each driver, the team could then link each unique instance
to shadowing table whenever the driver had additional concurrent activity. Distributions were
then created to show how often a specific activity occurred with a particular driver. This is
shown in Appendix W through Appendix AB.
Beeper Study
The team worked with the clients and coordinators to develop a methodology of data input,
which would reflect the proportional division of labor across units, and hours of the day.
The beeper study data is comprised of four sheets showing activities in each unit (PICU, NICU,
PCTU, and General Care Floors). In each sheet, there were seven tabs showing each day
throughout a whole week. In each tab, the team added up the number of a certain activity under a
specific period for a specific day based on the beeper study sheets collected from the therapist.
Therefore, the number showing in a cell represents the number of an activity in an hour period in
a specific day within a unit. The team used the Excel spreadsheets to create the graphs shown in
Appendix K – Appendix U.
FINDINGS AND CONCLUSIONS
The following findings were obtained from the analysis the team conducted on the shadowing
and beeper study data.
Shadowing
Using the Excel template for inputting our shadowing data (Appendix B), our team analyzed all
the data from the shadowing stage of our data collection. The main drivers, or activities, we
focused on were MDI, SVN, lung conditioning, equipment set-up, CPAP/BiPAP, vent
management, and communication and travel with no concurrent activities. The communication
driver included communicating with the C.S. Mott Hospital staff as well as the family members
of the patients. The reason for grouping both types of communication was because it was
determined to be more beneficial to see the time values therapists spent on communicating with
anyone.
We found that for CPAP/BiPAP, lung conditioning, and MDI, there were very few data points.
However, for the rest of the main drivers, a histogram was created in order to have a visual sense
of the main time range that depicted how long the therapists took for each main driver. Although,
the total times and average times for each activity were calculated, we were able to see the major
outliers with the histograms.
In addition, we used Microsoft Access to find the percent distribution for each concurrent
activity within the major drivers.
8
Frequency
SVN: Time Range and Corresponding
Frequency
16
14
12
10
8
6
4
2
0
0-5
6-10
11-15
16-20 21-25 26-30 31-35
Time Range (minutes)
36-40
41-45
46-50
Figure 1: SVN: Time Range and Corresponding Frequency
Vent Mgmt: Time Range and Corresponding
Frequency
Frequency
20
15
10
5
0
0-4
5-8
9-12
13-16 17-20 21-24 25-28 29-32 33-36 37-40 41-44 45-48
Time Range (minutes)
.
Figure 2: Vent Mgmt: Time Range and Corresponding Frequency
The Driver data was compiled to show is a list of each driver, along with the number of
occurrences, total time in minutes, median time per number of occurrences, mean duration, and
concurrent activities for each driver. Using Microsoft Excel, the team was able to find all fields
except for concurrent activities. Shown in Appendix V, each driver has its specific number of
occurrences, total time in minutes, median time per number of occurrences, mean duration, and
concurrent activities. A table of concurrent activity for the MDI driver is shown below in Figure
3.
9
MDI (Sample Size = 11)
Concurrent Activity
Frequency
Docum-Billing
64%
Pt. Assessment
64%
Secretion Mgmt
36%
Vent Mgmt
36%
SVN
27%
Comm-MD/RN/RT
18%
Equip Set-up
9%
Figure 3: MDI Concurrent Activity Distribution
Beeper Study
The percentage distributions of direct care, indirect care, and unscheduled care in different units
are shown in Table X. The total number of reported beeps for General Care Floors, NICU, PCTU,
and PICU is 913, 858, 778, and 682 respectively.
Figure 3: Distribution of Reported Beeps in Different Units
As the figure shows, General Care Floors reported the highest percentage for direct care, 59%,
whereas PCTU reported the highest percentage for indirect care, 48%. In addition, the percentage
for indirect care was slightly higher than the percentage for direct care.
10
On a daily basis, which is in a 24-hour period, there were some trends for each unit regarding
types of care. In General Care Floors, there was a peak two hours after the shift started for direct
care and a peak one hour after the shift started for indirect care. In NICU, there were two peaks
during each shift for direct care, two hours after the shift started and about three hours before the
shift ended. In PCTU, there was also a peak two hours after a shift started for direct care.
However, its percentage of reported beeps at the beginning of the morning shift was extremely
low. In PICU, a peak happened only one hour after each shift started for direct care.
After comparing four units’ percentages of reported beeps on both weekdays and weekend,
General Care Floors reported the highest percentage for direct care on weekdays, 61%, and
NICU reported the highest percentage for unscheduled care on the weekend, 18%. In General
Care Floors, PCTU, and PICU, the percentages of reported beeps for direct care and unscheduled
care on weekdays were higher than weekend, whereas the percentage for indirect care on
weekend was higher than weekdays’. In NICU, however, the percentages for direct care and
indirect care on weekdays were slightly higher than weekend’s and the percentage for
unscheduled care on weekend was much higher than weekdays’.
RECOMMENDATIONS
Due to the lack of clinical expertise, Team 8 is not able to give recommendations to upper
management for Respiratory Care at C.S. Mott Hospital.
EXPECTED IMPACT
As mentioned above, Team 8 lacks the clinical knowledge to make informed decisions about
how to change the care provided by respiratory therapists. However, the data that was collected
and analyzed by the group can be used by upper management for future work. With their clinical
background, upper management will be equipped to make decisions that affect workflow and
workload about pediatric respiratory therapists in C.S. Mott Hospital.
11
APPENDIX
Appendix A: Shadowing Data collection sheet
12
Appendix B: Shadowing excel template
13
Appendix C: Beeper Data collection sheet
Front side
Backside
14
Appendix D: Beeper Data Excel Template
15
Appendix E: Percentage of Care Type by Unit
Appendix F: Vent Mgmt: Time Range and Corresponding Frequency
Vent Mgmt: Time Range and Corresponding
Frequency
Frequency
20
15
10
5
0
0-4
5-8
9-12
13-16 17-20 21-24 25-28 29-32 33-36 37-40 41-44 45-48
Time Range (minutes)
16
Appendix G: Equip Set-up: Time Range and Corresponding Frequency
Equip Set-up: Time Range and
Corresponding Frequency
12
Frequency
10
8
6
4
2
0
0-1
2-3
4-5
6-7
8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23
Time Range (minutes)
Appendix H: SVN: Time Range and Corresponding Frequency
SVN: Time Range and Corresponding
Frequency
16
14
Frequency
12
10
8
6
4
2
0
0-5
6-10
11-15
16-20 21-25 26-30 31-35
Time Range (minutes)
36-40
41-45
46-50
17
Appendix I: Communication: Time Range and Corresponding Frequency
Communication: Time Range and
Corresponding Frequency
40
35
Frequency
30
25
20
15
10
5
0
0-1
2-3
4-5
6-7
8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23 24-25 26-27
Time Range (minutes)
Appendix J: Travel: Time Range and Corresponding Frequency
Travel: Time Range and Corresponding
Frequency
350
300
Frequency
250
200
150
100
50
0
0-1
2-3
4-5
6-7
8-9
10-11
Time Range (minutes)
18
Appendix K: General Care Floor Care Type Distribution
Percentage of Reported
Beeps*
General Care Floors
100%
80%
60%
40%
20%
0%
1
3
5
7
9
11 13 15 17 19 21 23
Hour
Percentage direct care
percentage unscheduled
Percentage indirect care
Appendix L: NICU Care Type Distribution
Percentage of Reported Beeps*
NICU
100%
80%
60%
40%
20%
0%
1
3
5
7
9
Percentage direct care
percentage unscheduled
11 13 15 17 19 21 23
Hour
Percentage indirect care
19
Appendix M: PCTU Care Type Distribution
Percentage of Reported
Beeps*
PCTU
100%
80%
60%
40%
20%
0%
1
3
5
7
9
11 13 15 17 19 21 23
Hour
Percentage direct care
Percentage indirect care
percentage unscheduled
Appendix N: PICU Care Type Distribution
Percentage of Reported Beeps*
PICU
100%
80%
60%
40%
20%
0%
1
3
5
7
9
Percentage direct care
percentage unscheduled
11 13 15 17 19 21 23
Hour
Percentage indirect care
20
Appendix O: General Care Floor Activity Distribution
Appendix P: PCTU Activity Distribution
21
Appendix P: NICU Activity Distribution
Appendix Q: PICU Activity Distribution
22
Appendix R: PCTU Weekday vs. Weekend Care Type Distribution
Percentage of Reported Beeps
PCTU
70%
57%
48%
60%
46%
43%
50%
40%
30%
20%
6%
0%
10%
0%
Direct
Indirect
Unscheduled
Care
Appendix S: General Care Floor Weekday vs. Weekend Care Type Distribution
Percentage of Reported Beeps
General Care Floors
70%
61%
49%
60%
51%
50%
34%
40%
30%
20%
5%
10%
0%
0%
Direct
Indirect
Unscheduled
Care
23
Appendix T: NICU Weekday vs. Weekend Care Type Distribution
Percentage of Reported Beeps
NICU
70%
60%
52%
50%
38%
50%
32%
40%
18%
30%
10%
20%
10%
0%
Direct
Indirect
Care
Unscheduled
Appendix U: PICU Weekday vs. Weekend Care Type Distribution
Percentage of Reported Beeps
PICU
70%
60%
54%
48%
42%
50%
35%
40%
30%
12%
20%
11%
10%
0%
Direct
Indirect
Care
Unscheduled
24
Appendix V: Driver Table
Drivers
Number of
Occurrences
Total Time
(mins)
Median
Time
Mean
Duration
(mins)
(mins)
Concurrent
Activities
MDI
11
205
16
18.64
See Table
SVN
43
603
13
14.02
See Table
Vent Mgmt
69
686
8
9.94
See Table
CPAP/BiPaP
9
86
8
9.56
See Table
Comm-All (NonConcurrent)
108
378
2
3.50
N/A
Travel (NonConcurrent)
395
401
1
1.02
N/A
Equip Set-up
45
319
5
7.09
See Table
Lung Cond.
9
111
15
12.33
See Table
Appendix W: CPAP/BiPaP Concurrent Activity Distribution
CPAP/BiPaP (Sample Size = 9)
Concurrent Activity
Frequency
Pt. Assessment
67%
Docum-Billing
56%
SVN
22%
Equip Rounds
11%
Order Mgmt
11%
Travel
11%
25
Appendix X: MDI Concurrent Activity Distribution
MDI (Sample Size = 11)
Concurrent Activity
Frequency
Docum-Billing
64%
Pt. Assessment
64%
Secretion Mgmt
36%
Vent Mgmt
36%
SVN
27%
Comm-MD/RN/RT
18%
Equip Set-up
9%
Appendix Y: SVN Concurrent Activity Distribution
SVN (Sample Size = 43)
Concurrent Activity
Frequency
Docum-Billing
67%
Pt. Assessment
58%
Secretion Mgmt
26%
Vent Mgmt
23%
Comm-MD/RN/RT
19%
Comm-Family
14%
Airway Mgmt
7%
MDI
7%
Order Mgmt
7%
CPAP/BiPaP
5%
Equip Rounds
5%
Lung Cond.
5%
Travel
5%
26
Appendix Z: Equip Set-up Concurrent Activity Distribution
Equip Set-up (Sample Size = 45)
Concurrent Activity
Frequency
Comm-MD/RN/RT
16%
Travel
11%
Vent Mgmt
11%
Airway Mgmt
9%
Docum-Billing
9%
Pt. Assessment
7%
Equip Rounds
4%
Page/Phone
4%
CPAP/BiPaP
2%
MDI
2%
Staff Assist
2%
Appendix AA: Lung Cond. Concurrent Activity Distribution
Lung Cond. (Sample Size = 9)
Concurrent Activity
Frequency
Docum-Billing
33%
Pt. Assessment
33%
Vent Mgmt
33%
Airway Mgmt
22%
Comm-Family
22%
Comm-MD/RN/RT
22%
SVN
22%
Order Mgmt
11%
Travel
11%
27
Appendix AB: Vent Mgmt Concurrent Activity Distribution
Vent Mgmt (Sample Size = 69)
Concurrent Activity
Frequency
Docum-Billing
52%
Pt. Assessment
45%
Comm-MD/RN/RT
23%
Secretion Mgmt
20%
Airway Mgmt
14%
Travel
9%
Comm-Family
7%
Equip Set-up
7%
MDI
6%
Lung Cond.
4%
Order Mgmt
4%
Staff Assist
4%
Alarm/Alert
3%
Equip Rounds
3%
Page/Phone
1%
28