The Respiratory Therapy Institute at Celebration Health takes a holistic approach to medicine by examining patients’ dietary, physical therapy, and cardiac needs.

A patient demostrates pursed lip breathing on a harmonica.

Mixing tradition with the cutting edge, the Respiratory Therapy Institute at Celebration Health, Celebration, Fla, focuses on treating all aspects of a person, not just their disease. “From the beginning, our goal at Celebration was not just treating the patient’s illness, but the whole person including mind, body, and spirit,” says Ed Fluker, RRT, director of respiratory care. “[For example,] our pulmonary rehabilitation program meets two times a week, and not only do the patients exercise each time, they receive an hour of an education program. This program goes beyond simply educating patients about their illnesses, respiratory anatomies, or how to take breathing treatments. We get into quality of life issues—things that go beyond the patient’s disease yet are important to them in their day-to-day lives, which are often overlooked.”

This holistic approach includes treating conditions and problems unrelated to respiratory illnesses. In many cases, solving these unrelated problems helps to alleviate the breathing problems. “Patients who come in for pulmonary rehabilitation are obviously there because they have some sort of breathing disorder, so we look at their dietary, physical therapy, and cardiac needs; we look at every aspect of the person,” Fluker says.

The pulmonary rehabilitation program shows the department’s commitment to its cutting edge and holistic aspects of treating patients. The department has received as many as 50 emails a day from organizations around the world asking how they can apply Celebration’s pulmonary rehabilitation methods—one method includes using harmonicas in breath retraining.

Harmonica Program
Fluker says the harmonica program was started for one simple reason—it is fun to play. “Playing a harmonica mimics pursed lip breathing. It provides resistance to both inspiration and expiration because you breathe out and in to produce a note. One of the problems we found when people exercise or perform breathing retraining is that it’s boring and redundant. So using something like a harmonica makes it more interesting and fun, yet achieves the same goal.”

The program originated with the germ of an idea. “About 2 years ago, we saw an article on asthma patients using harmonicas,” Fluker says. “So we thought about taking this idea and using it with our pulmonary rehabilitation patients because we were already using a breathing retraining device. It really caught on.” The staff has also learned how to play the harmonica. Therapists lead weekly practices and, on occasion, patients put on concerts to show off their new skills.

The Hospital
The 60-bed community hospital is one of seven institutions comprising the Adventist Health System-owned Florida Hospital network. With its neo-Mediterranean architecture, Celebration Health resembles a hotel rather than a community hospital. This atmosphere was created intentionally. “It creates an expectation of a five-star hotel,” says Terry Uhran, an administrator at Celebration. “When people go to a five-star hotel, they expect superior service and care. We want people to come in to our hospital with those same high expectations. When you walk in, there is a concierge, a registration counter, and wide-open space, which is nothing like a conventional hospital. The natural sunlight, windows, and artwork displayed throughout the building create an ambience that changes the mentality of [a hospital] having to be a sterile environment.”

Prevention is a theme that runs throughout Celebration. “We have several institutes that have been developed at Celebration Health to promote wellness through education and, if necessary, treatment. A lot of times education is not enough,” Fluker says.

Because the hospital focuses on wellness, approximately 25% of the Celebration facility is a 60,000-square-foot health club. The club members enter the gym through the same doors as the patients. This was done for a specific, psychological reason. “We have our members walk in with everybody else,” Uhran says. “It’s a positive environment for patients who are coming in for the healing process to be in the same environment as healthy people. We wanted to make sure a platform was created that would not only [address] illness and a healing process—more important, we wanted to build a fitness platform that hopefully would allow more people to go to the fitness center to improve their health rather than simply accessing our healing service.”

Smoking Cessation Program
This platform does not stop at the front doors of the hospital. Fluker and his staff take part in a variety of community-based programs including health fairs and school programs. One of the outpatient programs central to the department’s mission is Celebration’s Smoking Cessation Program. The Adventist Health System—reflecting the doctrines of the Seventh-Day Adventist Church—has been running this program for years, but it was only recently that respiratory therapists became involved. “About 21¼2 years ago, Florida Hospital approached me [and] the respiratory care department to try to find a more effective way to help people stop smoking,” Fluker says. “I really felt that the respiratory therapy department was the right avenue to work with smoking cessation. Since most of our careers have been spent working with the illnesses related to smoking, I think that respiratory therapists are uniquely qualified to work with smokers and understand what they’re going through.”

When the respiratory therapy-based program was started, 10 therapists completed training on smoking cessation counseling. The medically supervised treatment includes six, one-on-one 30- to 45-minute therapy sessions, a weekly support group, clinical testing, and antismoking medication. Fluker says the program has been effective with a success rate of 67% at 12 months and 88% of those patients finishing the initial stage of the program and achieving a quit date.

Asthma Initiative
Another program the respiratory department administers is Celebration Health’s Asthma Initiative, which is aimed at setting up a treatment protocol for pediatric asthma within the hospital. At Florida Hospital’s main campus, a pediatric asthma unit will soon be opened and staffed by a nurse practitioner and a respiratory therapist. “Another focus of this initiative is to set up outpatient asthma clinics for people in the community and provide free asthma education, as well as asthma self-management training, and to get them physician care for the medications that they need,” Fluker says.

This part of the initiative will target asthma sufferers who make frequent trips to the emergency department because of poor treatment compliance. Enrolling them in training programs will help them manage their asthma, which will improve their health and cut costs for Celebration’s emergency department.

Celebration’s respiratory therapists work throughout the hospital doing everything from performing endotracheal intubations to ventilator management to attending all cesarean sections to collecting blood for autotransfusions. The therapists’ patients cross every demographic line. “Lung disease is not a disease for the aged. It involves all different age groups.” Fluker says. Therapists are on duty 24 hours a day, 7 days a week with three on during the day and two throughout the night.

As part of the regional Florida Hospital system, Celebration serves both the town of Celebration and the surrounding area; however, one of the hospital’s goals is to become a destination hospital with patients traveling to Celebration from other states or countries for treatment. Fluker says between 60% and 70% of the respiratory therapy department’s patients are from out of the area.

Religious Ethics
As part of the Adventist Health System, Celebration Health is underpinned by the teachings of the Seventh-Day Adventists with its holistic, golden-rule, and God-centered approach to health care. Though it is directed by a religious ethic, the health center was inspired by an earthly icon, Walt Disney. “The town of Celebration was a dream of Walt Disney before he died,” Uhran says. “[He wanted] to build a community and an infrastructure—the architecture—that were similar to the values of a traditional 1940s type of community, but he also wanted it to be the most technologically advanced facility in the country as it relates to the educational system and the community.”

After successfully bidding to build the hospital, Florida Hospital purchased 66 acres from Disney World—which the town of Celebration adjoins—for the Celebration Health site. The health center that opened its doors in January 1998 has no affiliation with Disney.

Chris Wolski is an associate editor of RT Magazine.