title: Implementing therapist-driven protocols.
abstract: In January of 1993, as part of a hospital-wide cost-reduction strategy, the University of California San Diego (UCSD) Medical Center Respiratory Care Department implemented a patient-driven protocol program designed to utilize the assessment skills and judgments of respiratory care staff, within physician-approved guidelines. This program produced a 60% reduction in the use of hand-held nebulizer therapy and chest physical therapy in the institution, with a substantial decrease in operational expenses. This article describes key elements of the implementation of protocol-driven programs, provides examples from the UCSD experience, and offers insights gained from others who have been successful agents of change. It describes patient-driven protocols, how they can be implemented, the barriers to and promoters of such protocols, and what the results can be for a respiratory care department.
authors.affiliation: University of California, San Diego Medical Center, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Ford
authors.forename: J E
authors.initials: JE
authors.lastname: Phillips-Clar
authors.forename: D M
authors.initials: DM
authors.lastname: Burns
mesh_terms: D002985:Clinical Protocols; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D009936:Organizational Innovation; D010347:Patient Care Planning; D015397:Program Evaluation; D012138:Respiratory Therapy / Q000379:methods*