Responsibilities of the Medical Director of Respiratory Care

1. The Medical Director is responsible for the delivery of Respiratory Care Services and is accountable to the Medical Staff for the quality of patient care delivered by the Respiratory Care Service personnel. The Medical Director will provide 24-hour availability (including, where necessary, an appropriately qualified designee(s) to share these responsibilities or assume them in the Director’s absence).
2. The Medical Director interacts directly with the respiratory care personnel and promotes bedside and laboratory problem-solving and guidance.
3. With qualified technical assistance, the Medical Director balances the quality and cost-effectiveness of respiratory therapies and pulmonary physiologic testing, including blood gas analysis.
4. The Medical Director monitors and prevents mis-utilization of respiratory therapies and respiratory diagnostic services by appropriate audit techniques.
5. The Medical Director has expert knowledge and training in the use of respiratory care equipment and oxygen utilization in the hospital, home and extended care facilities, and advises the Medical Staff of indication for and regulations regarding these services.
6. The Medical Director formulates policies governing diagnostic and therapeutic procedures performed by Technical Staff, such as:
   • When under the Respiratory Care Service, sampling arterial/venous/capillary blood for gas analysis, measuring ventilatory parameters and inspired/expired gas concentrations, measuring ventilator weaning and artificial airway parameters.
   • Protocols for endotracheal tube and tracheostomy tube management and intubation, chest physiotherapy, ventilator management, aerosol and inhaled bronchodilator therapy.
7. The Medical Director participates in development, evaluation and introduction of new respiratory services, equipment, protocols and procedures, and also monitors current respiratory services for their continued medical usefulness.
8. The Medical Director provides Continuing Education in the diagnosis and treatment of lung diseases for Physicians, Respiratory Care Practitioners, Pulmonary Technologists, Registered Nurses, Administrators, Physical Therapists, Patients and the Community.
9. The Medical Director coordinates the respiratory services with Administration, the Medical Staff, Nursing, Pharmacy, Emergency Department, Critical Care Units, Post-Anesthesia Recovery Rooms, and other personnel who might utilize such services.
10. The Medical Director reviews physician performance in prescribing respiratory therapies, e.g., ensuring documentation of complete and appropriate physician orders or practices, therapeutic objectives, duration of therapy and response to therapies.
11. The Medical Director provides consultation to physicians with respect to availability and appropriateness of requested respiratory care and diagnostic services.
12. In the absence of a Medical Director of the Pulmonary Physiology Laboratory, the Medical Director of Respiratory Care may provide medical direction of the Pulmonary Physiologic Testing Laboratories, including blood gas analysis.
13. The Medical Director may coordinate special respiratory services for other units, which may include Respiratory Intensive Care Units, Pulmonary Rehabilitation Programs, Hyperbaric Oxygen Therapy Units, Smoking Cessation Clinics, Transportation of the critically ill patients within the hospital and between hospitals, Sleep Disorder Centers, and other programs which appropriately require participation from the Respiratory Care Service.
14. The Medical Director shares responsibility with and provides medical expertise to the Administrative/Technical Director of the Respiratory Care Service in matters regarding: Equipment; Personnel; Supplies; Budget; Space; Infection Control; policies and Procedures; Safety; Preventative Maintenance; Medical Gas Systems; Record Keeping; Fiscal and Regulatory Agencies and Disaster and Casualty Programs.
15. The Medical Director, as the agent of the Medical Staff, is responsible for seeing that the Respiratory Care Service is in compliance with Federal, State and JCAHO Regulations.

* Modified from an Official Position Statement of the California Thoracic Society, with permission.

REVISED AND READOPTED MARCH, 1997

REVIEWED APRIL 2006