Developed at the request of Congress by the National Heart, Lung, Blood Institute, the first ever published COPD National Action Plan was released on May 23, 2017 with input from the AARC, COPD Foundation, and the broad COPD community. The plan provides an outline for respiratory therapists and others to take coordinated actions to improve public awareness, management, and collaboration on research for COPD.
At the University of Cincinnati Medical Center (UCMC), a multidisciplinary team of respiratory therapists, physicians, pharmacists, social workers, and nurses have assembled to develop and implement a plan aimed at mitigating system-level failures, with the goal of reducing COPD inpatient readmission using a customized COPD care bundle.
Between October of 2015 and July of 2016, the overall 30 day all-cause COPD readmission rate fell from 22.7% to 14.7%, with nearly a 90% adherence to the COPD bundle components. For patients who had the complete COPD care bundle the readmission rate was even lower, at 10.9%.
Respiratory therapists were instrumental in the development of the bundle, from the very beginning stages of planning through the literature review, testing, training and implementation.
Today at UCMC respiratory therapists are responsible for carrying out two out of five components of the COPD care bundle: personalized inhaler education centered on discharged medications (based on insurance compatible inhaler brands) and the provision of standardized discharge instructions to the patient.
Among the obstacles we had to overcome to get to this point were variability of inhaler education among staff, amount of additional time to perform education above existing workload, standardizing inhaler handouts for patients and family to take home, and utilization of the EMR for RT notification of inhaler instructions.
The next phase of this project is to carry the momentum gained from the inpatient experience to the emergency department, main campus ambulatory clinics, and beyond.
To learn more about the UCMC inpatient COPD care bundle, read the abstract of their study published ahead of print by BMJ Quality & Safety on July 21.