Abstract
Background: The Lung Improvement Programme supports the implementation of the national COPD strategy and enables delivery of effective clinical practice through process improvement and redesign. Focussed on quality, productivity and innovation the work supports a practical approach to sustainable improvements across the whole care pathway.
Objectives: To develop redesigned pathways, new service models and transferable principles for COPD services in England to improve the patient experience and outcomes.
Methods: 50 improvement projects focussed on different steps of the pathway: diagnosis, acute care, chronic disease management, home oxygen services and end of life care. Through a national programme of peer support and application of service improvement tools, each project used data to form objective measures of change; diagnostic tools were used to understand the variation in provision and testing approaches to develop and refine news ways of working.
Results: Using 3 principles: administrative review, prescription optimisation and assessment and review, 7 home oxygen projects have demonstrated a total annualised cost efficiency saving of £590k. Other emerging principles that underpin effective care models are early accurate diagnosis, medicines optimisation, effective self management, managing high impact users, structured patient reviews, integrated care and using data to effect change.
Conclusion: There is variation in the delivery of services for COPD patients due to process duplication and system waste. A systematic improvement approach provides opportunities for significant productivity gains and at the same time reduces variation and costs, and improves quality and outcomes.
- © 2011 ERS