Breakout 1.3 The Implementation of a COPD Discharge Care Bundle: Why, How and Who? - Louise Sewell
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Transcript of Breakout 1.3 The Implementation of a COPD Discharge Care Bundle: Why, How and Who? - Louise Sewell
1
The Implementation of a
COPD Discharge Care Bundle:
Why, How and Who?
Louise Sewell
Clinical Lead for Pulmonary Rehabilitation
& COPD Nurse Specialists Services
Who? Why?
When? How?
2
Why?
3
Care bundle
UHL Local CQUIN
2012-13
COPD
Care
Bundle
Why?
• CLAHRC Rehabilitation
Implementation team – managed by
Sally Boyce
• Established team of COPD specialist
nurses – REDS team
• Busy Pulmonary Rehabilitation team
already providing post exacerbation
PR
• SPACE manual developed on site
• Supported by NHS Improvement
Lung team and COPD Network
Who?
4
Sept 2011
•Set up task &
finish group –
meet regularly to
discuss process,
paperwork and
implementation
May ’12-Mar 13 Jan 2012
•Contents of
bundle agreed
•Changes to
REDS team
management
•Staff SPACE
training begins
April 2012 Feb 2012
•REDS team
begin to pilot
bundle
•REDS team
deliver
bundle to all
their patients
• Local
£960000
CQUIN
commences
•COPD
transformational
funding
•6 and 9 month
data analysis
Implementation phase Operational phase
When?
5
COPD Care Bundle Process
Stage 1
Care Bundle delivered by REDS
prior to discharge
Stage 2
Post discharge phone calls by REDS@
2 days and 15 days
Stage 3
Assessment for Pulm Rehab
within 4 weeks of discharge
So where are we?
137127
1059392
78
99
10
49
8590
0
20
40
60
80
100
120
140
160
Mar
chApril
May
June
July
August
Septe
mber
October
Novem
ber
Decem
ber
January
# p
ts r
ecei
ved
car
e b
un
dle
Total to date = 965
6
REDS Care Bundle Data: Number of phone calls received per patient
0
10
20
30
40
50
60
70
0 1 2 3 4 5 6 7 8 9 10
# phone calls per patient
%
Q1 Q2 Q3
COPD Care Bundle Data: Smoking Status
7
COPD Care Bundle Data: Referrals to smoking cessation services
COPD Care Bundle Data: Referral to Pulmonary Rehabilitation
6
28
51 53 46 58 62
5373
0%
20%
40%
60%
80%
100%
AprilM
ayJu
neJu
ly
August
Septe
mber
October
Novem
ber
Decem
ber
missing data
not appropriate
declined
completed
8
Mean number of Pulmonary
Rehabilitation referrals per month
64 69
104
0
20
40
60
80
100
120
2010-2011 2011-2012 2012-2013
refe
rral
s (n
)
COPD Care Bundle Data: Length of Stay
2011-12 2012-13
9
COPD Care Bundle: patient feedback.
“I’m grateful for the support
and I’m going through the
SPACE manual with a fine
tooth comb, very helpful.”
Mrs M, aged 61
“I think the service you
provide is marvellous, I have
learnt so much from my
admission and feel more
confident with the
management of my COPD.”
Mr C, aged 74
“The information is very
good and well written but
I feel it should have been
done years ago as I feel
it’s too late for me but will
benefit lots of other
younger people with my
condition.”
Mr S, aged 82
“I think the service is
really helpful and the
SPACE book is
excellent…I have bought
some weights and am
using them three times a
week as it tells you to in
the book.”
Mr S, aged 82
Summary
• There is a more streamlined and efficient pathway in
place for all patients with COPD.
• The impact upon length of stay and readmissions
currently being explored.
• This is now being delivered to over 70% of COPD
discharges from Glenfield.
• Referrals to smoking cessation and pulmonary
rehabilitation are significantly increased.
10
Thanks…