November is National COPD Awareness Month and respiratory therapists all over the country are busy spreading the word about this chronic lung condition.
In Rochester, MN, Kris Hammel, RRT, RPFT, raises awareness of COPD every day on the job, with her patients, their caregivers, and her fellow clinicians. As the first chronic pulmonary disease clinical specialist at the Mayo Clinic, she has spent the past year building the hospital’s Hospital Readmission Prevention Program for COPD.
Hammel says patient education is a key part of the program. “All hospital RTs are expected to provide and reinforce basic COPD education on inhaled medications, airway clearance with PEP therapy, and pursed lip breathing,” says the AARC member. The Hospital Readmission Prevention Program takes it one step further by zeroing in on individualized care and education using the motivational interviewing technique.
Using a patient-centered care approach, she works with patients to ensure they thoroughly understand their medications and how to take them, teaches them relaxed breathing techniques and breath recovery, goes over airway clearance techniques and devices, and helps them learn how to identify the symptoms of an impending exacerbation. She measures their peak inspiratory flow when needed as well.
She is also charged with communicating with the hospital team, reporting the findings from patient assessments, developing and modifying the COPD care plan, and consulting with other departments involved in the patient’s care, such as nicotine dependence, pulmonary medicine, pulmonary rehabilitation, sleep medicine, palliative care, and nutrition.
After discharge, she makes sure her patients have the appropriate primary care provider appointments and she works with the RN care coordinators and durable medical equipment providers involved in the case. Together they come up with an ongoing plan of care for the patient.
Build your own
Right now, Hammel is the only RT in the chronic pulmonary disease clinical specialist position, but two more specialists will be added before the end of the year. Getting the job requires the Registered Respiratory Therapist credential plus two years of hospital experience. It also requires someone who is interested in helping patients manage their condition going forward.
“You have to be motivated to be at the bedside listening to the patient’s stories and working with them to develop a plan and empower them to manage their chronic lung disease,” says Hammel. Staying up-to-date on current research and best practice on preventing COPD readmissions is paramount.
With their solid background in respiratory physiology and pharmacology, she believes RTs are the right people for this position, especially if they take advantage of educational programs to bring them up to speed in the area like the AARC’s COPD Educator Course and Pulmonary Disease Educator Course (stay tuned for new dates in 2016).
Hammel also believes other hospitals could follow in Mayo’s footsteps and build a COPD Hospital Readmission Prevention Program of their own. She recommends these steps to anyone who may be interested in developing this role in their facility —
- Get support from your department/hospital leadership.
- Know what your hospital readmission rates are and where the gaps in quality of care are before you begin the program.
- Identify one person with the primary job assignment for a portion or all of the shift.
- Develop a simple, individual patient-focused plan for assessment that includes the multidisciplinary team.
- Identify a couple of your “frequent flyers” and start with the assessment tool.
- Have a consistent guideline for education tools and when to follow up post discharge.
- Prioritize the education needed and focus on only a couple of the items during the hospital stay, then follow up with the patient/primary care team post hospital discharge.