2011 NCSRC Newsletter, Issue 1
A Message from the NCSRC president
To the Members of the North Carolina Society of Respiratory Care:
I hope this message finds all of you well. As President, it is my responsibility to keep the members informed of things happening within your Society. This letter is to inform you that our Executive Secretary has resigned and our Central Office will relocate. There were many factors that went into this decision. In an effort to maintain transparency, I would like to provide you with a brief timeline of events that led to your Board of Directors making the choices they did.
When I accepted the position of President -Elect, it was a stated goal of mine to ensure the activities of our Board of Directors and Committee Chairs were in alignment with our ByLaws and Standing Rules.
September 15, 2009: The NCSRC BOD renewed the contract with our Executive Secretary. The Board made the decision to begin a complete review of the current contract prior to renewing in June 2011. The Board also began a review of our ByLaws and Standing Rules as it related to our elected positions and committee chairs.
April 2010: The NCSRC became aware of changes we needed to make regarding financial management. Primary concern was secure bonding of all persons handling finances for the Society.
May 17, 2010: The Executive Committee began discussions regarding the process of change. This process included informing our Executive Secretary of the need to obtain a surety bond for her financial services with us as well as a total review of the current job description for this position.
Sept. 28, 2010: The Board of Directors approved a revised job description for our Executive Secretary. Changes made to this job description included removal of tasks related to those tasks assigned to elected positions and committee chairs.
Current President, Jimmy Phillips, sanctioned a committee of outgoing and incoming members of the Executive Committee to review the Executive Secretary contract in preparation for negotiations.
November 2, 2010: The Board of Directors was notified of the inability of our Executive Secretary to be surety bonded for her financial services.
November 10, 2010: Executive Secretary was notified of the need to meet with her regarding transfer of financials to the Treasurer – this secondary to her inability to be bonded. This meeting was not to discuss the new contract.
November 19, 2010: The Board of Directors was presented with the proposed contract during closed session. The Board was informed of all changes to include reasons for each change. After discussion, the Board came out of closed session and approved the proposed contract. Executive Secretary was given a sealed copy of this contract at the end of the Board meeting for review.
November 21, 2010: A complete letter detailing the changes of the contract with explanation for each was sent to the Executive Secretary.
December 3, 2010: After several conversations, the Executive Secretary notified the Board of Directors she would complete her contract and not enter into further negotiations.
December 14, 2010: The Executive Committee met via conference call to discuss next steps in filling this position.
January 18, 2011: The Board of Directors met via conference call and was presented with recommendations from the Executive Committee. After much discussion, it was approved to hire an interim Executive Secretary. This position would be effective through December 31, 2011. The Board would post the permanent position in June 2011 with intent to have a permanent replacement on January 1, 2012.
January 31, 2010: Contract signed with interim Executive Secretary.
March 16, 2011: Interim Executive Secretary notified President that he would be unable to fulfill his contractual duties due to other employment.
March 18, 2011: NCSRC, Inc. begins application process for Executive Secretary position.
April 18: NCSRC, Inc. interview team will begin the interview process with all applicants.
It is important to me that you know what great representation you have in your Board of Director representatives. It has been a very busy year for the Society as you can see. This group of respiratory therapists have committed to serving you by making decisions – even tough ones – in the best interest of your Society.
I encourage each of you to visit our website – www.ncsrc.org. We have posted our new phone number (336-757-2247) and email address, ncsrc@ncsrc.org. We will remove the old contact information and will it will no longer be associated with the NCSRC effective Sunday, April 17, 2011. Please make note of these changes.
I have posted a brief job description and application for the position of NCSRC Executive Secretary. This position is open to anyone meeting qualifications. We are not requiring this position to be a respiratory therapist. If you know anyone who may be interested in applying for this position, please direct him or her to our website. We will begin the interview process the week of April 18.
Thank you for taking the opportunity to update yourself on changes within your Society. I am excited about the future of our Society and feel confident your Board of Directors and elected officials are making the right decisions on your behalf.
Mark your calendar – Annual Symposium in Wilmington, September 27 – 30, 2011.
Sincerely,
Jill Saye, President – North Carolina Society of Respiratory Care
jcsaye@novanthealth.org
Nominations Committee Reminder
We are seeking nominations for:
- President-Elect
- Vice President
- Treasurer
- Secretary
- Board of Directors-West x 1
- Board of Directors-Central x 2
- Board of Directors-East x 1
- No delegate election this year
Electronic nomination forms are available under Member Tools on the NCSRC website at www.ncsrc.org
It’s not too late! Nominate your peers and colleagues who you consider to be outstanding representatives of the respiratory therapy profession. Deadline for submissions is April 15th.
Thank you!
Nominations Committee:
Travis Houston, Chair
Trisha Miller
AARC / NCSRC PACT 2011 Update
Lawson Millner & Jill Saye of the NCSRC PACT participated in the AARC’s 2011 PACT DC Hill / Lobby Day on March 7-9. We were there again this year to ask our representatives to support HR 941, the Medicare Respiratory Therapy Initiative. This legislation will expand a Medicare patient's access to qualified respiratory therapists in physician offices.
We discussed why this legislation is so important to this patient population. One focal point is the costly hospital readmission rates for Medicare patients with COPD and pneumonia. We also pointed out that COPD is now the third leading cause of death and is the only one in the top ten on the rise. We stated that if this patient population had access to a respiratory therapist in the physician’s offices, this might drive down those readmission rates. Our reasoning is that a respiratory therapist could provide valuable education and expertise to improve patient outcomes. Patients could receive education on their disease process, spirometry, asthma education, smoking cessation, and training on proper use of inhaled medications without the physician being present.
We had quite a busy day with nine meetings. We were fortunate to meet with Representatives Renee Ellmers, Howard Coble and Brad Miller. We met with staffers from the offices of both Senators Burr and Hagan. We also met with staffers from Representatives Sue Myrick, Mel Watt, Heath Shuler, and Virginia Foxx. We had a patient from Pennsylvania with Alpha 1 join our meeting with Sue Myrick's office to help explain why this legislation is important from a patient perspective. Everyone we met acknowledged the importance of this legislation. While we did not get any cosponsors of the bill while we were there, we are still in touch with those we met with and encouraging them to cosponsor HR 941. As of now, the AARC is working to get a senate version of this bill introduced.
Thanks to everyone that has written your representatives to ask them to support HR 941. If you have not written, it is not too late. Ask your co-workers, pulmonary rehab groups, physicians, and patients to write. Simply follow this link to the AARC Capital Connections page and choose appropriate links http://capwiz.com/aarc/issues/.
As a follow up to this, many of you are aware that the AARC held a Virtual Lobby week February 25-March 8, 2011, where they were asking everyone to use Capital Connection to contact their representatives to support HR 941. There were just over 9,000 letters written through Capital Connection. The final tally as of March 10 showed that North Carolina was ninth overall with 296 messages sent. Michigan was first with 1027 messages.
One aspect to making each of these drives effective is a 435 plan. What this means is that the AARC tries to have one or two respiratory therapists and one patient advocate in each congressional district across the US to help spread the word in their congressional district. NC needs an updated 435 plan to cover our 13 districts. If you are willing to be one of the contact persons for your district, please email your info including district number to Lawson Millner @ rlmillner@novanthealth.org. Once we get a list of therapists, we will work on getting a list of patient advocates.
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Education and Program Committee Update
The Education and Program Committee has been working hard to make sure the 2011 NCSRC Symposium exceeds the standards we have set over the past years. The 2011 Symposium will be held at the beautiful Hilton Riverside Resort Hotel in historic downtown Wilmington, NC September 27-30. This will be our last half-day, two full-days, half-day format Symposium, or Tuesday through Friday Symposium. Beginning next year at the 2012 Symposium to be held at the Embassy Suites Hotel in Concord, NC, we will begin a three full-day formatted meeting held over a Wednesday through Friday. This three-day format will still feature the wide variety of topics required of our widely variable profession as well as nationally renowned and first-time speakers, which have become the standard for our Symposium.
The 2011 agenda is set and Tuesday features a Ventilator Workshop designed for student as well as seasoned practitioners to improve their skills in mechanical ventilation art and technology. An all-star team featuring three AARC Fellows will present this workshop: Mike Gentile, John Davies and Dr. Neil MacIntyre. Also on Tuesday, for the first time in our history, a session on Sleep Disordered Breathing will be presented will be held as a concurrent session to the Ventilator Workshop. More and more respiratory therapists are entering the world of sleep disorder screening, diagnosis and treatment not only in the staff role but also in the management role. We hope this session, which will feature AAST education credits as well as AARC education credits will draw both RRTs and RPSGTs.
On Wednesday, NCSRC President Jill Saye will preside over her final Business Meeting. Awards for Practitioner of the Year, Physician of the Year and Manager of the Year will be presented as well as AARC Scholarships to students. The program then features our two featured lectures, the Keynote Address and the Houston Anderson Memorial Lecture. This year, our Keynote speaker will be Senator William Purcell, MD, the leader in helping our profession gain licensure, and in establishing the North Carolina Respiratory Care Board. The Houston Anderson Memorial Lecture will feature Rich Branson speaking on the Current Status of Closed Loop Ventilation. The Shelton “Boogie” Dixon Memorial Vendor Hall will be packed with vendors, all of whom support our profession in many ways, also on Wednesday.
Thursday features concurrent sessions as well as the Inaugural meeting presided over by the incoming President and current President-elect Dr. Kim Clark. One hall will feature management and professional lectures that are not to be missed as we attempt to look into the future of our profession and how it will be shaped by legislative, financial, advocacy and regulatory agencies. This session will also prepare future respiratory therapists and practicing therapists who find themselves seeking new careers on what employers are looking for in the people they hire. This will be a lively and informative session. The other concurrent session will be purely clinical in nature, beginning with a patient lecture on his personal journey in receiving a lung transplant by Mr. Bill McManus. The rest of the clinical session will feature adult, pediatric and neonatal lectures by renowned physicians Toan Hyunh and William Miles, Ira Cheifetz and Robert Dillard, as well a panel discussion on Rapid Response Teams. Not to be missed on Thursday is a lecture by Dan Grady, RRT, RCP on the results of the NCRCB Ventilator Survey. The afternoon will wrap up with the triumphant return of the Open Forum Chaired by Research Committee Chairman and NCRCB Board Member Dan Grady, RRT, RCP.
We wrap up the Symposium on Friday morning with two excellent lectures on the role of respiratory therapists in obstructive sleep apnea and cardiopulmonary disease featuring Dr. Jason Thomason and Dr. Chuck Sherrill, both pulmonologists and both sleep specialists. These lectures will reveal a new opportunity for the unique education and skills of a respiratory therapist to be applied to a patient population desperately in need of our attention as healthcare providers.
The Program Committee consists of Kathy Short, Mike Gentile, Shelbourne Stevens, Harold Finn, Bill Kiger and Patti Kriegel. Can’t wait to see you in Wilmington in September!!
Sukhbaatar Aimag Hospital, Mongolia
Respiratory Equipment and Training Proposal
I have been approached by Kate Borkowski, a Peace Corps nurse, to provide respiratory equipment and neonatal/pediatric ventilator training for physicians, nurses, and anesthiologists in Sukhbaatar Aimag Hospital, located in Mongolia.
This is a rural hospital located outside the capital of Mongolia. They are in desperate need for the following disposable equipment (also reusable items):
Nasal Cannulas
Incentive Spirometers
ET tubes (size 2.5 – 8.8)
Sleeved suction catheters – all sizes
Ballard suction catheters – all sizes
Ambu bags
Any other disposable respiratory equipment
They would also like to have donated a neonatal/pediatric ventilator. Currently they only have adult ventilators. They would like potentially three days training/lecture and hands on practice to include the following:
Ventilator Set-up, troubleshooting, best practices, complications/issues with newborn/pediatric ventilation and disinfection/cleaning.
This is a wonderful opportunity for RT’s across NC to step up to the plate and participate in a great mission project! If you are interested in providing supplies/equipment or would like to volunteer your time, please send your contact information to:
Robin Ross, RRT,RCP
rross@cvcc.edu
The Intensivist Model and APACHE Scoring System
What Is Going On In ICU?
Dawn Turner, RCP
Mission Hospitals
Mission Hospital is embracing and encouraging a positive culture change to improve patient care. The initiatives of Zero Harm and Every Patient Every Time are goals that should now be familiar. Why is it so important for our patients that we embark on such a journey?
Annually approximately 4 million patients are admitted to the ICU and nearly 500,000 patients will not survive their stay. ICU patient mortality averages 10% - 20% in most hospitals and ICU accounts for 24% - 35% of hospital costs. What if we could accurately predict a patient’s mortality rate and use that data to improve patient outcomes.
Acute Physiology Age Chronic Health Evaluation APACHE is the tool used to facilitate this process improvement initiative. Globally APACHE IV is the gold standard for ICU measurement and is the leading solution to improve ICU quality and outcomes. APACHE is a severity scoring system utilized in Cerner that predicts mortality rates. The scoring ranges from 0 – 299 and calculates mortality in percentages from 0 – 10%, 10 – 40%, 40 – 80%, and >90% based on data entered into Cerner. Sedation, ventilation, and >50% FiO2 are just a few variables that negatively effect a patients outcome. Hence, we now understand the urgency to initiate sedation vacations, spontaneous breathing trials, and maintain oxygen saturations at 90% reducing the toxic FiO2 levels below 50%.
The intensives model and critical care improvement team goal is simple, improved patient outcomes. Early liberation from the ventilator must be initiated when applicable to deliver safe, effective, efficient, timely, patient centered, and equitable care.