Coalition Will Advance Patient Safety Initiatives to Reduce Adverse Events and Deaths Due to Respiratory Compromise – Respiratory Compromise recognized as a top Preventable Patient Safety Challenge
Today, the National Association for Medical Direction of Respiratory Care (NAMDRC) announced, with the support of key medical and healthcare stakeholders, the launch of the Respiratory Compromise Institute (www.respiratorycompromise.org) to drive actionable solutions that increase education about and reduce the incidence of respiratory compromise in inpatient hospital settings.
Organizations that form the Clinical Advisory Committee of the Respiratory Compromise Institute include:
- American Association for Respiratory Care (AARC)
- American College of Emergency Physicians (ACEP)
- American Society of Anesthesiologists (ASA)
- American Thoracic Society (ATS)
- American College of Chest Physicians (CHEST)
- National Association for Medical Direction of Respiratory Care (NAMDRC)
- Physician-Patient Alliance for Health & Safety (PPAHS)
- Society of Critical Care Medicine (SCCM)
- Society of Hospital Medicine (SHM)
According to the U.S. Department of Health & Human Services, Agency for Healthcare Research and Quality, Respiratory Compromise is the third most rapidly increasing hospital inpatient cost in the United States, with $7.8 billion spent on Respiratory Compromise in U.S. hospitals in 2007. Respiratory Compromise increases patient mortality rates by over 30 percent and hospital and ICU stays by almost 50 percent. The Institute defines Respiratory Compromise as a state in which there is a high likelihood of decompensation into respiratory insufficiency, respiratory failure or death that could be prevented or mitigated through specific interventions (enhanced monitoring and/or therapies).
“Preventing or mitigating decompensation is critical because nearly any patient could be at risk and succumbing quickly to Respiratory Compromise,” said Tim Morris, MD, President of NAMDRC and Chair of the Institute’s Clinical Advisory Committee. “One minute you have a patient who is doing fine and within a few minutes the patient rapidly deteriorates to a dangerous point of no return. In many cases, if we could detect this deterioration earlier, we could prevent the need for massive intervention.”
Respiratory Compromise, which includes respiratory distress, insufficiency, failure and arrest, can occur across numerous clinical scenarios. For example, Respiratory Compromise may appear post-operatively or may be drug-induced by the delivery of a sedative, opioid, or analgesic to patients who were not properly assessed or properly monitored.
“In addition to increasing hospital stays and costs, respiratory compromise drastically increases a patient’s chances of dying, yet most instances may be preventable,” said Michael Wong, JD (Executive Director, PPAHS). “In the past year, several stories about unnecessary deaths due to Respiratory Compromise have made headlines and increased public awareness of this issue, and it’s reassuring to see so many members of the medical community join us to seek solutions.”
The Respiratory Compromise Institute will provide education to the medical community and general public. As well, the Institute is strongly committed to supporting a broad range of research that will assist health professionals in identifying useful monitoring and therapies, identifying high, moderate and low risk patients, and crafting educational tools to disseminate research findings.
“Bringing about actionable change in clinical practice to reduce the risk of respiratory compromise is the goal of the Respiratory Compromise Institute,” said Phil Porte (Executive Director, NAMDRC). “On behalf of our member organizations, the Respiratory Compromise Institute will soon issue a report that reviews the challenges of addressing Respiratory Compromise, as well as the pathway for solutions.”
Actionable solutions that the group has identified include:
- Developing a standardized patient risk assessment tool to identify those at risk for developing respiratory compromise.
- Requiring electronic monitoring for high-risk patients, including continuously electronically monitoring with pulse oximetry for oxygenation and capnography for adequacy of ventilation, as recommended by the American Society of Anesthesiologists, The Joint Commission, and many other healthcare organizations.
- Improving continuous training of clinicians regarding the signs and treatment for respiratory compromise.
- Increasing the understanding and knowledge of medical conditions that precipitate respiratory compromise among all hospital staff.