Abstract
Background: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common respiratory diseases in the UK, causing around 25,000 deaths a year and with a large portion of patients not receiving ideal care for COPD exacerbations. Care bundles, a sequence of evidence based interventions, have been identified as a way of delivering consistent patient care.
Aims: National Institute for Health Research (NIHR) Collaboration for Applied Health Research and Care (CLAHRC) for Northwest London implemented COPD discharge care bundles across 7 sites over 18 months (beginning in April 2009) to improve compliance to existing evidence based interventions.
Methods: The COPD discharge care bundles initially included smoking cessation, pulmonary rehabilitation, patient information on self-management, inhaler technique training, and follow-up appointment. Each of the sites adapted the bundle according to available resources and local settings. Weekly data on compliance was entered into a web reporting tool.
Results: The results from the data showed that 1052 patients were discharged with the care bundle; 668 of these patients were discharged having received all the elements of the care bundle (63.5% were fully-compliant). The bundle element with the highest overall compliance was smoking cessation with 95.2%, and lowest was recorded with the follow-up appointment at 77.8%. Overtime improvement to overall compliance was seen across all sites.
Conclusions: This study reveals aspects that impact compliance of care with COPD care bundle elements. The findings offer valuable lessons to future sites interested in implementing COPD care bundles and should be considered in order to improve COPD care.
- © 2012 ERS