High-value Care for Long-Term Ventilatory Care Patients

From the 2023 HVPA National Conference

Michael Wong JD (Physician-Patient Alliance for Health & Safety), Gene Gantt RRT, FAARC (Eventa)

The Enhanced Respiratory Care program is based on standards published by the American Association for Respiratory Care (AARC), which achieved liberation rates of 65% and earned national recognition of excellence from the American College of Chest Physicians (CHEST). Implemented in 2002 in Tennessee as part of TennCare’s plan to improve enhanced respiratory care quality, this program saw resource utilization rates double from an average of $350 to $700 per day. 

A committee composed of the following members looked at the TennCare program to develop Standards of Care:
Thomas M. Fuhrman, MD, MMSc, FCCP Chief of Anesthesia, Bay Pines Veterans Affairs Healthcare System – Tampa Bay, Florida
Clyde Heflin MD, FACCP – Pulmonologist – Nashville, Tennessee
Pam Clayton RN, LNHA – VP Quality, Regulatory Affairs at GA Health Care Association
Carrie Ermshar MBA, LNHA – Senior Care Executive Consultant, Houston, Texas
William Beal RRT, Massachusetts Board of Respiratory Care – Norwell, Massachusetts
Lisa Zaenger RRT, VP of Staffing at PEL/VIP – Oak Lawn, Illinois
Zachary Gantt RRT, FAARC, President and CEO Encore HealthCare – Livingston, Tennessee

This Committee developed the Enhanced Respiratory Care Standards of Accreditation for Long-Term Ventilator Facilities, which have been endorsed by the AARC and are anticipated to be endorsed by the Respiratory Compromise Institute, which is composed of these organizations:

American Association of Nurse Anesthetists, American College of Chest Physicians, American College of Emergency Physicians, American Society of Anesthesiologists, American Thoracic Society, National Association of Clinical Nurse Specialists, National Association of EMS Physicians, Physician-Patient Alliance for Health & Safety, Society of Anesthesia & Sleep Medicine, Society of Critical Care Medicine, Society of Hospital Medicine


The Enhanced Respiratory Care program consists of two facets:
Certification of Clinicians in Enhanced Respiratory Care to educate clinicians on the Enhanced Respiratory Care Standards; and Accreditation of Healthcare Facilities in Enhanced Respiratory Care to accredit healthcare facilities on the Enhanced Respiratory Care Standards.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog