SickKids

Department of Respiratory Therapy – Academic, Research and Clinical Practice
 
It is certainly an exciting time for Registered Respiratory Therapists at SickKids as we navigate towards a new era within the field of Respiratory Therapy. Due to the leadership of the RT Advisory Council, we have been successful in attaining a new direction for our profession; one which encompasses not only a focus on skills but one which also includes innovation, expertise, leadership and mentorship regarding respiratory care.
 
Clinical and technical skills will always be an important aspect of the RT role but we must extend beyond this to advance our profession and ensure dedication to innovation and respiratory care expertise.
 
The development of a RT Vision and Mission Statement for our profession at SickKids was important in providing us with a direction and long term goals.
 
Vision: To provide excellence and leadership in paediatric cardio-respiratory care, education and research.
Mission: As integral members of the inter-professional team we will ensure:
 
  • Professional excellence
  • Innovation through research
  • Education and knowledge sharing
  • Advocacy for our patients
  • Collaborative inter-professional teamwork
  • Respectful and compassionate care
  • Advancement of the Profession

Our Journey To Implementation…

We had a lot of work to do and a long journey ahead of us…

Some of our future goals included the following:

  • Move forward together as a profession to achieve excellence in patient care and become leaders in respiratory therapy practice
  • Bring Registered Respiratory Therapists together hospital wide to provide a forum where expertise can be shared
  • Collaborative Work – Inter-Professional Practice – Research
  • Professional Fulfillment – Education – Professional Development

SickKids

RT Governance Model – Professional Practice Structure

One of our first steps to achieving our goals was the implementation of an RT Advisory Council.

This council’s mandate is to provide a global framework to advocate and support respiratory therapy professional practice, education and research at SickKids. The council brings RTs together to provide a forum where expertise can be shared. The council also provides leadership and direction in promoting excellence in family-centered and evidence based respiratory therapy practice. Membership includes RT representatives from all areas within SickKids to ensure staff RTs have an active voice and contribute to the future direction of the profession.

Respiratory Therapy Professional Practice Groups (PPGs) have also been implemented in the various programs. The co-chairs and staff RT representatives from each PPG are active members of the RT Advisory Council. This facilitates ongoing communication between RTs, provide a platform for knowledge transfer and a vehicle to ensure standardization of RT practice.

The PPGs provide a strong communication link for clinical activities related to the provision of respiratory care within each program. The PPGs will address, evaluate and make recommendations on issues related to respiratory care practices and will be in a position to develop goals / strategies, evidence based clinical guidelines and / or policies and procedures to support and advance respiratory care practice within their respective programs. The PPGs are responsible for making recommendations to the Program Advisory Committee within their area regarding changes to respiratory care practice.

Key RT Advisory Council Objectives:

  • Standardize practice to attain a high level of credibility throughout SickKids which will support role advancement and consistency in the provision of best patient care.
  • Develop mechanism to standardize and evaluate RT Practice.
  • Advocacy for the RT Profession.
  • RT Advisory Council to be viewed as a voice/forum for policy approval at SickKids.

Additional initiatives that have been implemented:

  • Respiratory Therapy Newsletter – inspiringtimes
  • SickKids Respiratory Therapy Web Page
  • Commitment to RT Education and Professional Development – Yearly Education Days for all RRTs
  • Recognition of Staff RT Professional Practice and Expertise -Yearly RT Awards Ceremony and Tea –Awards for Excellence in Respiratory Care Practice – New Award – The Lianna Hart – Respiratory Therapy , Family Centred Care Award (Sponsored by the Hart Family – Inspired by the NICU RT Team)
  • RT Advisory Council successfully viewed by the organization as a forum for key stakeholder input and policy approvals.
  • RT Quality Assurance Program – developed by the RT Education Team and the RT Council to support the RTs as leaders in the delivery of high quality, accountable pediatric care by adhering to safe practice.The goals of the program is to facilitate staff awareness of policy and procedure/guidelines related to their practice and encourage staff to question practice and make recommendations for continuous improvement.

SickKids RTs in Research…

Respiratory Therapists are actively involved in research at SickKids. Recently, there has been a steep incline with many RTs participating in protocol development, REB applications, multi-centre study co-ordination, patient recruitment and publications. There are over 15 research projects in which RTs are currently involved with.

Some examples include the following:

  1. Prospective Evaluation of Respiratory Failure in Children after Cardiac Surgery.
  2. The Relationship Between Oxygen Delivery and Consumption During Extracorporeal Membrane Oxygenation.
  3. Tolerability and Physiologic Impact of Non-Invasive Continuous Positive Airway Pressure in Infants and Children with Acute Respiratory Failure.
  4. What happens to Oxygen Saturation after Discharge in Outpatients with Acute Bronchiolotis?
  5. A national birth cohort study involving 5000 subjects to determine what aspects of the environment interact with genetic factors to affect children’s health and development, in particular asthma and allergies.
  6. COT trial Canadian oxygen trial looking at whether hi vs low saturations impacts incidence of BPD, death.
  7. NIPPV trial looking at preterms <30 wk <1kg on either NCPAP or NIPPV and the impact of these therapies on BPD, death.
  8. Efficacy and safety study of denufosol tetrasodium inhalation solution in patients with cystic fibrosis lung disease.

SickKids RT STATs

  • 110 RRTs at SickKids
  • SickKids Resuscitation Advisory Group and Organizational Resuscitation initiatives are led by an RT.
  • SickKids Learning Institute – Simulation Program is lead by an RT.
  • First ever infant pulmonary function lab in Canada is lead by an RT.
  • 4 RRTs with dedicated time for clinical research.
  • 9 RTs on the Acute Care Transport Service ( Most of which are advance practice RTs working under the direction of 14 medical directives).
  • 18 RTs are ECMO Specialists who initiate ECMO and are the primary care givers for all patient’s requiring ECMO in the CCCU.
  • Greater than 7 RT Research Publications over the past 3 – 4 years.
  • Greater than 5 National and International Presentations by SickKids RTs over the past 3 – 4 years.
  • Through sponsorship of Children’s Heartlink, SickKids RTs were members of an inter-professional group from SickKids who traveled to China to assist with cardiac surgeries, post-operative care and education for the healthcare team.
  • Credentialing review group for all Regulated Health Professionals is led by an RT.
  • An RT awarded for the first time a Clinical Fellowship with 150 hours of protected time to work on a project (Amplitude-integrated EEG the Next Step: An evolution of aEEG use in the NICU at SickKids Hospital).

Zelia Da Silva

Professional Services Director

Department of Respiratory Therapy

The Hospital For Sick Children