MANAGING CLINIC DEMAND AND QUALITY OF CARE

Wayne Thompson is the sleep lab coordinator at the Sleep Disorders Centre, Misericordia Health Centre in Winnipeg, Canada. Given his 20 years of experience in Polysomnography, 15 years of that as a coordinator, Biowaves was interested to learn how the sleep lab environment has changed over that time.

BioWaves: What are your responsibilities at your sleep lab?

Wayne Thompson: I oversee 22 PSG staff members, order and evaluate equipment, train staff, execute sleep studies, coordinate and participate in research, manage the sleep studies database and act as liaison among the lab, the public and Manitoba Health Region.

BioWaves: Sounds pretty busy. How many patients do you see in your sleep lab monthly?

Wayne Thompson: We do 280 in-lab studies and 200 home-based studies. The physicians see between 300-400 patients a month either pre- or post-sleep study.

BioWaves: Have things changed in terms of the role or practice of sleep technologists over the past two decades you’ve been working in this area?

Wayne Thompson: Yes, there’s been a lot of change that has required a higher skill level for PSG techs. We’re definitely seeing more complex cases as the result of demographic shifts. Age and obesity factors, for example, have meant heavier, sicker patients coming through our doors.

We are also seeing many more patients with neuromuscular disease such as post-polio, ALS and MS who require nocturnal ventilation. The majority of end-stage neuromuscular patients resist invasive therapies (i.e. ventilator and/or tracheostomy), so we help ongoing assessment of their nocturnal breathing changes and manage them with non-invasive breathing support therapies.

BioWaves: What are key challenges facing your sleep lab right now?

Wayne Thompson: Time is a huge factor as demand for our services continues to grow. Along with that time crunch comes the challenge of maintaining high quality sleep studies and patient care.

BioWaves: How is your sleep lab addressing these challenges?

Wayne Thompson: We are in the process of setting up controls to monitor staff performance in order to evaluate overall efficiency and productivity. This will help us to more effectively evaluate quality assurance measures.

This evaluation will help management make decisions about workload issues such as hiring more staff or adopting technology that can improve productivity.

BioWaves: What do you do to foster best practice within your team?

Wayne Thompson: We strive to instill a culture where taking pride in one’s work is valued. PSG techs have a unique ability to improve quality of life for their patients through their knowledge of polysomnography, respiratory physiology and patient care. We stress the importance of our techs maintaining expertise in these areas.

Staff members are required to earn 10 educational credits per year as part of their performance evaluation. There are opportunities to get credits in-house and externally. With our current quota of scoring 4-5 sleep records per day at 1-3 hours required per chart, there aren’t many hours available for learning. But even simple opportunities can be beneficial such as reviewing case or technical issues in a group setting.

I make an attempt to teach and share my knowledge with our technologists and encourage them to share their knowledge with others as well. I truly believe that fostering a learning environment is important for our lab in an effort to keep turnover low. When there isn’t the time or opportunity for personal and professional development, people start to feel their time here is more of a job than a career choice. Each person needs to be a stakeholder and feel that they are making a valuable contribution toward running the Centre.

• Do you experience challenges in your sleep clinic? Can you share ways you’ve addressed challenges successfully? We’d love for you to share your comments with us.

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