Outcomes research as a tool for defining the role of respiratory care practitioners in the intensive care unit setting.

The impact of respiratory care practitioners on the outcomes of critically ill patients has not been examined in a systematic manner. This is in contrast to clinical investigations which have demonstrated the beneficial influence of specially trained critical care physicians and nurses on patient outcomes in the ICU setting. Outcomes research represents a method for the formal evaluation of various healthcare provider staffing patterns within the ICU. Specific patient outcomes including hospital mortality, respiratory complications, lengths of stay, and medical care costs can be used to determine the optimal ICU staffing strategy for respiratory care practitioners. Until recently, we have lacked good outcomes data for assessing the role of respiratory care practitioners in the ICU. Several barriers have contributed to this deficiency of data including a lack of funding, absence of a national research initiative aimed at this specific issue, and the paucity of clinical investigators in this area of study. Good outcomes research requires appropriate levels of funding, adequately trained and experienced clinical investigators from various disciplines (e.g., statistics, epidemiology, general medical sciences), and the support of both local and national organizations with an interest in respiratory care services and their impact on patient outcomes. To accomplish these research goals, an organized and dedicated approach must be developed based upon strong research proposals. This will allow advances to be made in the area of outcomes research as it relates to the role of respiratory care practitioners in the ICU. Similarly, the methods of outcomes research can be employed to better define the benefits and limitations of other ICU practices.