Staffing respiratory care positions has long been challenging for health care leaders, and the COVID-19 pandemic only exacerbated those concerns. A 2021 National Board for Respiratory Care report highlighted two troubling trends: nearly 100,000 respiratory therapists (RTs) will leave the profession by the end of this decade, and enrollment in respiratory care education programs in the U.S. has declined 27% since 2010.
Leadership at Riley Children’s Healthsaw the signs firsthand. Indiana University Health (IU Health), of which Riley is a part, lost 70 RTs in 2022, many citing the emotional toll of the position. Vacancy rates reached 50%, calling for an overhaul of the organization’s recruitment and retention practices.
“We needed to get team members in here so we could decrease the amount of contract labor,” said Beth Summitt, RRT-NPS, MA, executive director of Respiratory Care and Diagnostic Services at IU Health Academic Center. “There’s a cost savings, but most importantly, it's the very best for patient care.”
To address these challenges, Summitt and leaders and team members from across the organization launched a focused recruitment project in late 2022. The group devised a series of initiatives in three areas: education, culture, and advocacy.
Educational programs
The pandemic led to low enrollment and graduation rates at the two respiratory care educational programs in the health system’s region. Of those, only 17 — about 36% — took jobs at IU Health. Nurturing that RT pipeline was a priority for Summitt and her team.
IU Health surveyed educational program directors to understand what the students wanted and adjusted their recruitment efforts accordingly. Adjustments included:
- Switching recruitment presentations to the fall semester — instead of the spring — to get a foot in the door with graduating seniors sooner.
- Holding respiratory therapy assistant (RTA) and registered respiratory therapist (RRT) openings for qualified candidates until after graduation.
- Increasing knowledge sharing from RT professionals — including guest lectures and Q&A sessions with RTs that attracted more than 100 respiratory care students.
These initiatives contributed to more students staying in school and graduating. The associate degree programs reported a 29% increase in retention rates and, for only the second time in program history, 100% of the bachelor's degree students advanced to their senior year.
Those gains paid dividends for IU Health: 37 students accepted respiratory care jobs (including student positions) in the health system in 2023, compared to just 29 the prior year.
Internal culture
The recruitment project initiated significant changes on-site to ensure a top-notch clinical experience for respiratory care students. These changes included:
- A dedicated preceptor team and preceptor recognition program, which includes credits for professional development activities, such as continuing education courses or professional conferences.
- More touch points between staff members and students. In one semester, the project team recorded 88 deliberate meetings with 47 seniors in the program — with each student making at least one connection.
- Online student hubs specific to each location, giving students easy access to information on the hospital, their preceptors, important contacts, and job opportunities.
- A new peer recognition platform.
- A revised mentoring program.
Additionally, the respiratory care team rounds more frequently with physicians to assist with care decisions. “Being able to voice our opinion using our clinical expertise helps our team feel valued and appreciated,” Summitt said. “And in building that welcoming environment for students and new graduates, we find it nurtures a welcoming culture for experienced team members as well.”
The numbers bear that out, in the project’s first year, IU Health nearly doubled its overall number of respiratory care new hires — from 33 in 2022 to 60 in 2023.
Advocacy
The project led to a significant legislative win for respiratory therapy in the state. According to Indiana state law, students with permits to practice respiratory care cannot work in pediatric settings. Working with lobbyists from IU Health and the Indiana Society for Respiratory Care, Summitt got the restriction lifted.
“I'm so proud of that work, and the students are excited because some of them already know they want to work in pediatrics,” Summitt said. “It's a big win for the students and for the program.”
Next steps
Summitt plans to continue expanding the pipeline of available candidates. Her next step is to work with the region’s professional society to visit every high school in the state in the coming year.
“I'm really excited about that,” Summitt said. “Although we would ideally start reaching them at eighth grade, right now we need to really prioritize awareness at high schools.”
