A simple multifunctional tool for integrated care of COPD

Introduction: National UK initiatives to drive quality improvement in COPD have led to integrated care models. The success of this approach depends on engagement of, and communication between, several health care providers (HCPs). An important outcome measure involves COPD exacerbations. Aims & Objectives: To determine whether there has been a reduction in (a) hospital length of stay and (b) readmissions after discharge, for COPD exacerbations, after implementation of a pathway based on a simple proforma shared across all HCPs. Methods: We have developed a seamless COPD patient pathway, to be used from time of hospital admission and continuing in the community. It contains a 9discharge bundle9 section, designed to ensure all aspects of care are addressed and that the respiratory team are informed at the earliest opportunity. It is supported by an ongoing educational programe. Results: There was a significant reduction in length of stay in COPD patients admitted Oct-Dec 2017 following implementation of this tool, compared to Oct-Dec 2016 (Fig 1) and an 80% reduction in 30 day readmissions. There was no significant change in 30-day mortality. Conclusions: We have demonstrated, within a brief time frame, the success of this simple tool in facilitating early hospital discharges and safe ongoing management in the community.