Every RT knows that as soon as a patient is intubated a plan is formed to strategically liberate the patient from mechanical ventilation and then extubate the patient by the safest and most expeditious means possible. One could almost say that a patient is always intubated with a view to extubation.
In Chronic Disease Manager section of the March edition of the AARC Times, I believe I hear Kimberly S. Wiles, BS, RRT, CPFT, suggesting that this strategy, familiar to and even somewhat distinctive of the respiratory therapist, can perhaps be employed in the transition of COPD patients to the post- acute setting. In her words, “For a successful transition to occur, an emphasis must be placed on the discharge from the time of admission.”
Her contention is that “the transition of quality care should begin in the hospital and continue into the post-acute care setting (and that) as RTs, we play a major role in this continuum and should be involved from admission to discharge and beyond.” This is especially true for the reduction of COPD readmissions.
The difference is that we have strong evidence-based practice for the liberating patients from mechanical ventilation. However, this “room with a view to discharge” approach is fairly open territory! There are many parts in place, but not really an established best practice.
Does this represent one of those opportunities? In the March 2013 edition of the AARC Times, AARC President George Gabler spoke of when he said, “In many cases, respiratory therapists will be at the forefront of disease management as long as we can seize the opportunities as they become available in hospitals and other care sites.”