Sunday, Nov. 10 Gazette

Congress-goers rock out at Welcome Party

AARC Congress 2019 Welcome Party

AARC Congress 2019 Welcome Party.

The first day of the Congress is often a whirlwind of activity. Last night, Congress-goers were ready for a little rest and relaxation, and they found it at the Welcome Party. Great entertainment livened everyone’s spirits, and complimentary refreshments kept them well fed too.

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President’s report

By Karen S Schell DHSc RRT RRT-NPS RRT-SDS RPFT RPSGT AE-C CTTS

AARC President Karen Schell

AARC President Karen Schell.

It is not about what we are, it is about what we can become. — Dr. Seuss

Why are we here? Where are we going? A quote by John F Kennedy states, “Efforts and courage are not enough without purpose and direction.” Imagine if we waited until we were 100% sure about the outcome before we started anything. We would spend a lot of time waiting to begin, wouldn’t we? The outcome is never truly certain. Many of us have been feeling, when do we begin?

Well, the AARC has been on a journey. It may have felt like we have not even started to go to where we need to be for the future of the profession, but we began years ago with a vision, a future for respiratory therapists as equal partners in the health care arena. Now all the work from the past is forging our future. We have purpose and direction.

Our past leaders and members have laid the groundwork to build the foundation to develop a plan to move ahead to meet the needs of our profession and our patients. There have been obstacles along the road. We have kept going anyway, despite the fear, and despite the uncertainty. As Michael Angier states, “Real courage is moving forward when the outcome is uncertain.” Thanks to our past leaders, our organization, and our members, we have had the courage to pursue the vision.

Why we are here is important, but to know where we are going is imperative. It’s not what we’ve got, it’s what we do with it and how we use it to make a difference for the profession. Our time has come. We know where we need to go. We know where we need to be to advance the profession. Now the real work begins.

The AARC will continue to work toward achieving the six Horizon Goals implemented at the beginning of 2019 to go to where we need to be for our future. Those goals are --

  • We need to advocate for our patients with respiratory therapists who are recognized and supported in all health care settings.
  • We need to communicate our message to all stakeholders providing research-based outcomes and market the value of respiratory therapists.
  • We need to grow our educational opportunities and become a valuable resource to the practice of respiratory therapy.
  • We need to be recognized as the number one provider of respiratory therapy educational opportunities to all inter-professionals.
  • We need to grow our membership and encourage all populations to be involved in promoting the profession for the best patient outcomes.
  • We need continue to explore opportunities for the AARC to seek revenues to fund our mission and education and meet the needs of our patients and membership.

Since, January of 2019, the AARC, Board of Directors, House of Delegates, and stakeholders have made progress on these new goals. Some of the work being done is listed below.

Goal #1 — Advocacy

  • The BREATHE Act (HR 2508) was introduced in early May and now has 40 co-sponsors. PACT day was a success, with a record number of contacts to the Hill prior to the PACT members visiting their state representatives. (Visit www.congress.gov for the most current update).
  • The AARC has been contacting many offices on the Hill to address the CMS addition of noninvasive ventilators to the competitive bidding process.
  • The AARC signed a brief with key public health organizations to have the FDA conduct a product review of e-cigarettes and vaping products and put notice out to the public about the risk of vaping.
  • The AARC has been working with a lobbyist and our own Anne Marie Hummel to have a voice on key issues facing the health and reimbursement of care with our patients.

Goal #2 — Communication/Marketing

  • AARC Board members and the president have been traveling to state society meetings, updating members, encouraging “grass roots” support, and informing members of the progress of committee work, special representatives, and collaborative efforts in moving the profession forward to the BS degree entry level.
  • We are working with the AARC Executive Office to develop marketing tools promoting the respiratory therapist and encouraging student enrollment.
  • We are working with stakeholder organizations to share information affecting the health of our patients, such as allergy issues on flights, and smoking and vaping.
  • The Life and Breath video is to be rebooted — the new title will be, Be an RT.
  • We will be supporting the Safety Awareness March next year in Washington DC to bring attention to deaths caused by medical errors.
  • We are collaborating with stakeholders to market the RT.

Goal #3 — Education/Professional Development

  • An AS to BS Conversion Committee was appointed to assist in moving to the BS entry degree.
  • An issue paper, Entry to Respiratory Practice 2030, has been published.
  • We are investigating an RT Computer Application System (CAS) or Allied Health CAS.
  • The Program Committee developed both the Summer Forum and Congress programs.
  • Four webcast conferences have been held with the Committee on BS to Entry to Practice.
  • We have created a career pathway PowerPoint presentation for educators to promote entry to practice, updated the Bureau of Labor and Statistics on accurate statistics for the profession, and created video testimonials for different pathways to complete the BS.
  • 9 requests have been received for the AARC Vision Grant.
  • CHEST published the article, “Adequacy of the Provider Workforce for Persons with Cardiopulmonary Disease,” that was completed by the AARC.
  • The Advanced Practice Respiratory Therapist (APRT) scope of practice has been developed.

Goal #4 — Events/Meetings

  • Attendance was at an all-time high at AARC Congress 2018.
  • The international community is promoting the practice of respiratory care globally
  • Next meetings:
    • Summer Forum 2020: Snowbird, UT
    • Summer Forum 2021: Bonita Springs, FL
    • AARC Congress 2020: Orlando, FL
    • AARC Congress 2021: Phoenix, AZ

Goal # 5 — Membership

  • Membership currently stands around 45,000 and has been rising slowly. We are working on initiatives to recruit members through various committees. 
  • We are involving the specialty sections in increasing membership.
  • We are engaging students and members to “grow” the profession.

Goal #6 — Revenue and Finances

  • Quarterly review by the board.
  • Yearly audit completed.
  • Yearly report on investment.
  • IT upgrade completed.
  • Providing services within the budget.

Hard work opens doors and shows the world that we are serious. We need you to use the fullness of your talents to do our very best. We have been working hard, but the work is not done. We have much to do. We need your help. I encourage you to consider the words of Malcolm Gladwell, “If you work hard enough and assert yourself, and use your mind and imagination, you can shape the world to your desires.”

Welcome to New Orleans, I hope you have a wonderful Congress. I hope to meet many of you during the next few days. Enjoy your time together and make the most of the opportunity to learn, network, and engage.

Please feel free to contact me any time. You can reach me at karen.schell@aarc.org
Thank you for your support, and wherever life plants you, bloom with grace!

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Secretary-treasurer’s report

Lynda T Goodfellow EdD RRT AE-C FAARC

AARC Secretary-treasurer Lynda Goodfellow

AARC Secretary-treasurer Lynda Goodfellow.

As of September 30, 2019, the AARC is in good fiscal standing. The Executive Office and the Board of Directors continue to provide fiscally responsible leadership and oversight for the members of the organization. This includes quality educational program planning, advocacy for patients with lung disease, and persistently emphasizing the value of respiratory therapists at all levels of government.

I am pleased to report that the AARC financials for 2019 continue to perform better than plan, with both revenues and expenses better than budget. Revenues from publication advertising are down but digital online ads exceed expectations, while education revenues are up more than 9% due to the Disease Educator course. Other income received comes from grants, rental income, and corporate partners. Expenses are lower than expected, and this includes almost $400K in affiliate revenue sharing to the state societies. Furthermore, the AARC has done well with the chaotic stock market, with more than $3 million in unrealized gains.

Membership: Total membership at the end of September was over 45,000 members. Active membership reached over 40,000 members. Student membership recovered from 2018 totals at the same time, with approximately 500 more early professional members.

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President Schell addresses annual business meeting

AARC President Karen Schell

AARC President Karen Schell.

AARC President Karen Schell DHSc RRT RRT-NPS RRT-SDS RPFT RPSGT AE-C CTTS reviewed the progress the AARC has made during her first year in office and talked about plans for 2020 at this morning’s annual business meeting.

“Our future is created by what we do today and every day,” she told her audience. “Success will be the result of our hard work, learning from our failures, loyalty, and persistence. The past explains how we got here, but our future is up to us to define.” 

Dr. Schell will continue to work toward the six Horizon Goals established by the AARC at the beginning of her term —

  • We need to advocate for our patients with respiratory therapists who are recognized and supported in all health care settings.
  • We need to communicate our message to all stakeholders providing research based outcomes and market the value of respiratory therapists.
  • We need to grow our educational opportunities and become a valuable resource to the practice of respiratory therapy.
  • We need to be recognized as the number one provider of respiratory therapy educational opportunities to all inter-professionals.
  • We need to grow our membership and encourage all populations to be involved in promoting the profession for the best patient outcomes.
  • We need continue to explore opportunities for the AARC to seek revenues to fund our mission and education, and meet the needs of our patients and membership.

“If we work hard, it will improve our chances of succeeding,” concluded Dr. Schell. “I believe amazing things will happen when we all work together. Our patients need all of us to grow the profession.”

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Donald F Egan Scientific Memorial Lecture: Asynchrony — Detection, Clusters and Outcomes

Lluís Blanch

Lluís Blanch presenting the Egan Lecture.

Patient-ventilator asynchrony can impact patient outcomes, and tomorrow morning Lluís Blanch MD PhD will shed some light on the topic in the Egan Lecture. In addition to covering the various types of asynchrony, Dr. Blanch will address new technology that can automatically detect these mismatches and facilitate patient care.

“Mechanical ventilation in critically ill patients needs to effectively unload inspiratory muscles and provide a safe ventilation — enhancing gas exchange and protecting the lungs and the diaphragm,” says Dr. Blanch. “To do that, the ventilator should be in synchrony with patient’s respiratory rhythm.” He believes the complexity of this interplay leads to several concerning issues that clinicians should be aware of and able to recognize, and that asynchronies between the patient and the ventilator may induce several deleterious effects that require a proper physiological understanding in order to recognize and manage. 

“Appropriate handling of asynchronies requires clinical skills, physiological knowledge, and suitable drugs management,” notes the physician. “Additionally, new technologies and devices are currently changing our daily practice, going from automated real-time recognition of asynchronies and their distribution during mechanical ventilation, to smart alarms and artificial intelligence algorithms based on physiological big data and personalized medicine.”

Lluís Blanch is a senior intensivist and consultant in critical care at Centre Hospital de Sabadell in Barcelona, Spain. He also serves as research and innovation director at Corporació Sanitària Parc Taulí in Barcelona, and director of the University Institute Fundació Parc Taulí Universitat Autònoma of Barcelona. He has published extensively on topics related to mechanical ventilation.

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