The Evolution of the Safe and Effective Staffing Guide (SESG)

The New 2025 Release

What was previously known as the AARC Uniform Reporting Manual has been utilized for over 40 years and has evolved into the Safe and Effective Staffing Guide (SESG). The 2025 SESG includes additional resources and new tools, as well as updated content from the 2020 Safe and Effective Staffing Guide. This newest edition includes a set of statistical tables from which validated activity time standards are derived, and the methodology to determine your own time standards for activities not included in the SESG. In addition, the SESG  features new content to assist in the implementation of staffing programs and systems. Concepts such as application of Value Efficiency, Clinical Practice Guidelines (CPGs), Patient Driven Protocols, and hospital information systems to further enhance staffing efficiency and improving the quality of services are included. The SESG is also rich in references and examples of favorable outcomes achieved across the country by implementing SESG methodology. These references include a hyperlinked bibliography, and most importantly, case studies on how to engage hospital leadership to support an approach to staffing driven by the science of labor management. The SESG remains the recognized Gold Standard in identifying activities associated with the provision of respiratory services and the time required to perform each of those activities.

The AARC SESG is designed to assist leaders with:  

• Understanding the benefits of using staffing metrics that are driven by the clinical needs of patients and the value of such care.  

• Access to nationally validated procedure time standards, scope of care, and best practice.  

• Methodology to apply the concepts of Time Weighted Units of Service, Value Efficiency, and development of a cost-effective staffing plan.  

• Tools, references, case studies, pre-configured workbooks, and accounts of best practices that provide a wealth of knowledge regarding staffing programs and how to successfully implement them. 

The data, methods, and concepts included in the SESG can be applied in budget planning, shift-by-shift allocation of staff, and reporting productivity. Systems developed and described will assist in evidence-based staffing decisions and can be adapted for expansions and changes to service programs. The SESG will also assist in identifying trends in service utilization and forecasting demand for devices, capital equipment, and supplies.

The Activity Time Standards included in the SESG are the result of a nationwide survey completed by Respiratory Care Leaders, who submitted activity time standards currently in use at their facilities. Survey data were then analyzed, resulting in the publication of validated activity times.  

This guide is designed for Respiratory Care Leaders, Administrators, Medical Directors, and others responsible for managing staffing and ensuring safe and efficient use of labor resources.  The AARC SESG Expert Panel provided their experience, expertise, time, and extraordinary commitment to create this resource.  

Guide Contributors: Expert Panel, Support Staff, Case Study Authors, and Subject Matter Experts

The AARC SESG was developed by a team of exceptional leaders across the country, highly skilled and passionate about assisting others in implementing safe and effective staffing. In addition, the authors of the activity time standards reported that there were over 150 respiratory care leaders in the country that submitted their data through the 2025 SESG Time Standards Data Collection project. 

Expert Panel

Development Team

Co-Chairs

Advisor

Executive Office Liaison

Statistical Experts

Case Study Authors and Subject Matter Experts

Survey