While no one is confident of the specific direction these discussions will take, it is likely that not only will the proceedings be documented for submission for publication, but it may very well lead to other conferences that focus on respiratory compromise in other settings. Both the skilled nursing facility and long-term acute care hospital settings provide care for a spectrum of pulmonary/ventilator patients, and the characteristics of their potential cascade of deterioration may or may not be the same as in an acute care hospital. The challenges are similar, but solutions may be different—a subject for further discussion.
This conference is just one example of NAMDRC’s approach to a range of pulmonary-related clinical issues. While NAMDRC’s broad mission is to “improve access to quality care for patients with respiratory disease by removing regulatory and legislative barriers to appropriate treatment,” the roundtable does fit into the mission because of growing concerns that we are facing challenges that are solvable if we take the initiative to address solutions to these challenges.
Another very broad challenge facing NAMDRC is its belief that the growing area of home mechanical ventilation is being shaped by archaic and outdated legislation and regulation. In fact, in a discussion with Marilyn Tavenner, CMS Administrator (and critical care nurse by training) last August, she conceded that the laws and regulations have not kept pace with innovations as basic as noninvasive mechanical ventilation. The idea that mechanical ventilation involves intubation or tracheostomy is universally recognized as archaic. As archaic is the concept that, by definition, ending mechanical ventilation leads to imminent death. While that may have reflected technologies of the 1980s and early 1990s, it is not reflective of today’s standards of care. Amending the existing laws and regulations in this area may become a high priority for NAMDRC over the next few years.
For membership information, visit the NAMDRC website at www.namdrc.org or call 703/752-4359.