Sometimes therapies are discontinued after RT request, but even these requests often go unheeded. Why is this?
According to "Egan's Fundamental's of Respiratory Care," JCAHO standards recommend that all orders must specify the type of medicine, frequency, and duration of treatment."
Where I work JCAHO has been fired, and ISO has been hired. ISO is an organization that allows businesses to write their own rules and regulations, and it makes sure the hospital follows the rules and regulations it sets for itself. I'm sure it's more complicated than that, but that's the jist of it.
I don't know why JCAHO was fired (I call it fired), but from other RTs I have heard a lot of bad things about JCAHO. ISO, however, isn't necessarily any better. Except, from what I see here, it doesn't set regulations such as making it mandatory to write an order for duration of therapy.
The result of this is Q4-ever treatments on everyone.
I know some hospitals I used to work for had a standard protocol to put a sticker on the chart where the RT would recommend the treatment be renewed or that it was no longer needed, and the doctor could respond to this to make sure un-needed procedures were stopped.
Egan's also recommends that the doctor specify the goals and objectives of therapy. I imagine our hospital switched to ISO because the admins here, perhaps, are aware that there really is no purpose to most breathing treatments.
In fact, Egans states, "Unfortunately, adding goals and objectives to the respiratory care order does not assure that the therapy is needed. To be cost effective, all therapy must be justified and discontinued when no longer needed."For some reason, the admins at Shoreline medical don't care that un-needed therapies are given. This seems to be a trend across the board for RT departments across the nation.
I have a pretty good feeling the reason for this is the desire to keep the procedure count up in our department to justify having RTs here.
If that's not the reason, then I'm am baffled.