Decreasing Hospital Readmissions Utilizing an Evidence-Based COPD Care Bundle.
Chronic obstructive pulmonary disease
Discharge planning
Disease exacerbation
Hospital readmission
Transitions of care
Journal
Lung
ISSN: 1432-1750
Titre abrégé: Lung
Pays: United States
ID NLM: 7701875
Informations de publication
Date de publication:
08 2022
08 2022
Historique:
received:
10
01
2022
accepted:
31
05
2022
pubmed:
8
7
2022
medline:
11
8
2022
entrez:
7
7
2022
Statut:
ppublish
Résumé
Chronic obstructive pulmonary disease (COPD) is a chronic condition that leads to significant morbidity and mortality. Management of COPD hospitalizations utilizing an evidence-based care bundle can provide consistent quality of care and may reduce readmissions. This single-center retrospective cohort study evaluated readmission rates in patients hospitalized with a COPD exacerbation. Patients in the pre-intervention cohort received usual care, while patients in the post-intervention cohort received an innovative inpatient COPD care bundle. The bundle focused on optimizing care in five areas: consults, inpatient interventions, education, transitions of care, and after discharge care. In this study, 149 subjects were included in the pre-intervention cohort and 214 subjects were included in the post-intervention cohort. Thirty-day readmission rates were lower in the post-intervention cohort compared to the pre-intervention cohort, 22.4% vs. 38.3% (p = 0.001). A reduction in 60-day and 90-day readmission rates was also observed, 13.7% vs. 40.3% (p < 0.001) and 10.1% vs. 32.2% (p < 0.001), respectively. Bundled care is an effective and inexpensive method for institutions to provide consistent and quality care. The findings of this study demonstrate that the implementation of a COPD care bundle is an effective strategy to decrease hospital readmissions.
Identifiants
pubmed: 35796786
doi: 10.1007/s00408-022-00548-9
pii: 10.1007/s00408-022-00548-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
481-486Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Global Initiative for Chronic Obstructive Lung Disease (GOLD). Strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease, 2021 report. 2021. www.goldcopd.org/ . Accessed 30 Nov 2021.
COPD Burden | American Lung Association. American Lung Association | American Lung Association. https://www.lung.org/research/trends-in-lung-disease/copd-trends-brief/copd-burden . Accessed 30 Nov 2021.
Shah T, Press V, Huisingh-Scheetz M, White SR (2016) COPD readmissions: addressing COPD in the era of value-based health care. Chest 150(4):916–926
doi: 10.1016/j.chest.2016.05.002
Press VG, Au DH, Bourbeau J et al (2019) Reducing chronic obstructive pulmonary disease hospital readmissions. An official American thoracic society workshop report. Ann Am Thorac Soc. 16(2):161–170. https://doi.org/10.1513/AnnalsATS.201811-755WS
doi: 10.1513/AnnalsATS.201811-755WS
pubmed: 30707066
pmcid: 6812156
Stone RA, Holzhauer-Barrie J, Lowe D et al (2017) COPD: who cares when it matters most? National Chronic Obstructive Pulmonary Disease (COPD) audit programme: outcomes from the clinical audit of COPD exacerbations admitted to Acute Units in England 2014. National Supplementary Report. Royal College of Physicians, London
The Centers for Medicare and Medicaid Services. Hospital readmissions reduction program (HRRP). https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program . Updated August 8, 2021. Accessed 30 Nov 2021
Institute for Healthcare Improvement. Evidence-based care bundles. http://www.ihi.org/Topics/Bundles/Pages/default.aspx . Accessed 30 Nov 2021
Gómez-Angelats E, Sanchez C (2018) Care bundles after discharging patients with chronic obstructive pulmonary disease exacerbation from the emergency department. Med Sci 6:63. https://doi.org/10.3390/medsci6030063
doi: 10.3390/medsci6030063
Laverty AA, Elkin SL, Watt HC et al (2015) Impact of a COPD discharge care bundle on readmissions following admission with acute exacerbation: Interrupted time series analysis. PLoS ONE 10:e0116187
doi: 10.1371/journal.pone.0116187
Ko FW, Cheung NK, Rainer TH et al (2017) Comprehensive care programme for patients with chronic obstructive pulmonary disease: a randomised controlled trial. Thorax 72:122–128. https://doi.org/10.1136/thoraxjnl-2016-208396
doi: 10.1136/thoraxjnl-2016-208396
pubmed: 27471050
Rinne ST, Resnick K, Wiener RS et al (2019) VA provider perspectives on coordinating COPD care across health systems. J Gen Intern Med. 34:37–42
doi: 10.1007/s11606-019-04971-2
Lima CA, Oliveira RC, Oliveira SAG et al (2020) Quality of life, anxiety and depression in patients with chronic obstructive pulmonary disease. Rev Bras Enferm 73(Suppl 1):e20190423. https://doi.org/10.1590/0034-7167-2019-0423
doi: 10.1590/0034-7167-2019-0423
pubmed: 32667477
Pooler A, Beech R (2014) Examining the relationship between anxiety and depression and exacerbations of COPD which result in hospital admission: a systematic review. Int J Chron Obstruct Pulmon Dis 9:315–330
doi: 10.2147/COPD.S53255
Itoh M, Tsuji T, Nemoto K, Nakamura H, Aoshiba K (2013) Undernutrition in patients with COPD and its treatment. Nutrients 5(4):1316–1335
doi: 10.3390/nu5041316
Collins PF, Yang IA, Chang YC, Vaughan A (2019) Nutritional support in chronic obstructive pulmonary disease (COPD): an evidence update. J Thorac Dis 11(Suppl 17):S2230–S2237. https://doi.org/10.21037/jtd.2019.10.41
doi: 10.21037/jtd.2019.10.41
pubmed: 31737350
pmcid: 6831917
Yohannes AM, Connolly MJ (2003) Early mobilization with walking aids following hospital admission with acute exacerbation of chronic obstructive pulmonary disease. Clin Rehabil 17(5):465–471. https://doi.org/10.1191/0269215503cr637oa
doi: 10.1191/0269215503cr637oa
pubmed: 12952150
Chou W, Lai CC, Cheng KC, Yuan KS, Chen CM, Cheng AC (2019) Effectiveness of early rehabilitation on patients with chronic obstructive lung disease and acute respiratory failure in intensive care units: a case-control study. Chron Respir Dis 16:1479973118820310. https://doi.org/10.1177/1479973118820310
doi: 10.1177/1479973118820310
pubmed: 30789023
pmcid: 6322091
Restrepo RD, Alvarez MT, Wittnebel LD et al (2008) Medication adherence issues in patients treated for COPD. Int J Chron Obstruct Pulmon Dis 3(3):371–384. https://doi.org/10.2147/copd.s3036
doi: 10.2147/copd.s3036
pubmed: 18990964
pmcid: 2629978
Rohde J, Joseph A, Tambedou B et al (2021) Reducing 30-day all-cause acute exacerbation of chronic obstructive pulmonary disease readmission rate with a multidisciplinary quality improvement project. Cureus. 13(11):e19917
pubmed: 34976520
pmcid: 8712235
Melani AS, Bonavia M, Cilenti V, et al. (2012) Inhaler mishandling remains common in real life and is associated with reduced disease control [published correction appears in Respir Med. 106(5):757. DelDonno, Mario [corrected to Del Donno, Mario]]. Respir Med. 2011;105(6):930–938.
Hegelund A, Andersen IC, Andersen MN, Bodtger U (2020) The impact of a personalised action plan delivered at discharge to patients with COPD on readmissions: a pilot study. Scand J Caring Sci 34(4):909–918
doi: 10.1111/scs.12798