Decreasing the Number of Missed Therapies

Background: Missed therapies were identified as having a major financial impact on our respiratory department. During pay period 16, the total number of missed therapies was 1,054 with an average of 29 RTs with greater then 15 missed therapies. This creates a financial burden on the RT department as well as results in patients missing out on life-saving treatments. A goal was set to decrease missed therapies by 10%. Methods: To identify the primary causes of missed therapies, a missed therapy report was initiated, which tallies missed therapies for each employee. This allows the supervisory team to schedule a face-to-face meeting with each employee that has greater then 15 missed therapies in a pay period. During this sit down the team was able to identify the three most prevalent reasons were 1. Continuous patient refusals. 2. Charting errors. 3. Time management. Resolution to the three above causes, is to identify the reasoning, provide education and develop an action plan, and or follow-up with the employee as needed. Results: By identifying the most impactful causations, we would expect to see an overall decrease in missed therapies as a department and for the individual employees with a high percentage of missed therapies. Conclusions: Over the past 90 days we were able to identify the key factors that were contributing to missed therapies were charting errors as well as continuous patient refusals. The end goal was to re-educate the RTs during the face-to-face meeting and lower the rate of missed therapies. Looking back to where we started the study, pay period 16 had a total of 1,054 missed therapies to our most current studied pay period 23, which had 662. This is a decrease of 46% in missed therapies. There was also a decrease in the number of RTs with greater then 15 missed therapies in a pay period, from 29 to 7. We have concluded that the reeducation process and the awareness to staff that there will be a continuous review of bi-weekly missed therapies reports holding staff accountable.