"lecture"

One thing they should also remember is that these people are sleep deprived and not necessarily firing on all cylinders. I wasn't, I had a hard time understanding some of the stuff on this board and I was a systems analyst and computer programmer used to surfing and find obscure code to to strange things. After 2 weeks on the mask I suddenly understood everything on the site. So don't think your training is going to sink in right away, it won't because it can't because we are not getting the required REM sleep for it to register.
However since we are sleep deprived it is easy to impress us and get our total loyalty (which is why sleep deprivation is used for brainwashing) so just some feel good service and caring follow up will probably get you a loyal customer for life who will probably bring in over $40,000 at the DME over their life span. Every business course you take emphasizes the importance of repeat business and word of mouth business, my DME didn't get that and I have steered people AWAY from that business. The manufactures have already made this easy for you be creating crappy masks and humidifiers that are only supposed to last a few months so people are required to keep on spending money on the crap. This is considered a brilliant business move.

Tell your audience that therapy is not something done to patients. It is something patients do.

Give realistic information about the dangers of PAP therapy. There are many in the industry who have a wildly exaggerated notion of of how dangerous it is. This leads them to exclude patients from participating in their own therapy. And that causes the therapy to fail.

Tell them that if they don't focus on sleep at least as much as on apnea, they are missing the point.

Otter wrote:Tell your audience that therapy is not something done to patients. It is something patients do.

Give realistic information about the dangers of PAP therapy. There are many in the industry who have a wildly exaggerated notion of of how dangerous it is. This leads them to exclude patients from participating in their own therapy. And that causes the therapy to fail.

Bravo, excellent point!

A badly adjusted CPAP machine is bad.
A patient who stops doing CPAP is worse.

RDawkinsPhDMPH wrote:Several points:

1) I have been asked to give a presentation at the state sleep meeting on compliance programs. Of course, I will talk about our program but I also wanted to get any suggestions from the forum members. The audience will be mostly sleep techs from the labs and RRTs or sleep techs from DMEs, and will include some sleep docs.Thanks.

I would ask the direct question:

Why do they all (or at least mostly all) fear:
Prescribing an auto CPAP (APAP) to their patients
Letting & even suggesting that their patients use the available software to track their own progress AND to titrate their
own pressure (all of the studies show that at home self-titration is just as good as that done in a sleep lab).
Either they come along for the ride (even if it will be bumpy) or we will leave them at the campsite.

Hope I'm not too late on this.

There's an old management principle that applies to compliance on xPAP devices. "That which gets measured gets done."

http://www.enotes.com/greatest-manageme ... iple-world

And there are plenty of psychological studies that show that the more something is observed the more people work to make it work. Remember the study where researchers tried to find out how much light impacted the ability of a group to work, even when they took more and more light away from the manufacturing workstation? The amount of light did not matter. The amount of observation did. The more the work was observed, the greater the performance of the workers.

How does this apply to xPAP devices? If the doctor, RRT and/or DME *REALLY* want to be certain their patients use the contraptions then MEASURE it! Call up the patient and ask for "blower hours". Ask how they are doing. It takes time and effort. But I guarantee the compliance (and almost certainly the business) will increase dramatically.

There is a corollary to this management principle: "What are you *really* measuring?"

In this case, if the doctor, the RRT and/or the DME only seem to care about sales, and NOT the success of the patient, the patient will know it and have NO desire to participate. So, measure patient success. Measure something that MATTERS TO THE PATIENT.

Hope that helps.

JohnBFisher wrote:Hope I'm not too late on this.

There's an old management principle that applies to compliance on xPAP devices. "That which gets measured gets done."


In this case, if the doctor, the RRT and/or the DME only seem to care about sales, and NOT the success of the patient, the patient will know it and have NO desire to participate. So, measure patient success. Measure something that MATTERS TO THE PATIENT.

Hope that helps.

Yes I remember my industrial stats courses from the 70's - Just the fact that things are perceived to be measured will increase the quantity and quality of the work. Humans like to be watched, to be paid attention to.

It's the "Hawthorne effect" .... the famous study was done at the Hawthorne factory to determine how to increase the workers' speed and efficiency. As stated earlier in this thread, it was the watching that improved the workers' speed--the environmental changes didn't have any impact.

And to reiterate this fact, I don't think I'm the only person here who realizes that without the data to monitor my progress, I would not have been able to stick with it through the initial tough times. My adjustment to xpap was NOT easy or smooth, but looking at the graphs and numbers every day gave me the sense of competing with myself to see how long I could keep the mask on, what could I tweak to improve my numbers, etc. etc. etc.

If I had had no knowledge or understanding of any of this, I would have packed it up after the first week.

I continue to be grateful to all the people on this board who so willingly share their knowledge.


Weezy

BlackSpinner wrote:... Yes I remember my industrial stats courses from the 70's - Just the fact that things are perceived to be measured will increase the quantity and quality of the work. Humans like to be watched, to be paid attention to.

Bingo!

DocWeezy wrote:... It's the "Hawthorne effect" .... the famous study was done at the Hawthorne factory to determine how to increase the workers' speed and efficiency. As stated earlier in this thread, it was the watching that improved the workers' speed--the environmental changes didn't have any impact. ...

THANK YOU! I was pulling a complete blank.

It's a simple principle. Any seller of any product can DRAMATICALLY improve their customer satisfaction by simply asking how things are going on a periodic basis. In my job with several computer , I had to help fix complex problems. Sometimes I could not be on the phone with the customer without our lawyers being on the phone. Within days our lawyers and the customers lawyers decided that level of monitoring was not needed. Often a HORRIBLE situation would turn into a multimillion dollar deal. Why? Because I would ASK ... and keep on asking. I would then follow the customer for a year or more to be certain things remained stable.

It's a simple principle that seems to be VERY hard for most organizations to implement. Successful organizations implement it and often can not coherently explain why it matters. They just know it does. Not knowing why it matters is important. During cost cutting adventures, it can lead to cutting the wrong things. Revenue can suffer dramatically if you stop taking the time to ask.

Wulfman Den succinctly states the more important items.

At my initial xPAP indoc in 05, the tech at my DME (the much-maligned Apria) suggested that if we can avoid humidification that we should, further suggesting that the chances of success are greater without it. Keeping that advice in mind, I eschewed humidification, and for me it works quite well. (I did experiment a bit, and found HIGHER ahi with anything but passover mode humidification).

Hope the presentation goes well.

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