Question

One of the “hot buttons” regarding COPD is the attempt to minimize the number of 30-day readmissions. What has your institution done in this area? What programs or procedures would you suggest to minimize this issue? How would you implement them? Why?  

Answer 1

Chromic obstructive pulmonary disease(COPD) is a group of lung diseases that block airflow and make it difficult to breathe.

Emphysema and chronic bronchitis are the most common conditions that make up COPD.Damage to the lungs from COPD can't be reversed.

To manage COPD:

• Systemic glucocorticoids have an essential role in the management of patients hospitalized for COPD exacerbation.
• Hospitalized patients with exacerbations should receive regular does of short-acting bronchodilatrs,continuous supplemental oxygen,antibiotics and systemic corticosteroids.
• Non-invasive positive pressure ventilation or invasive mechanical ventilation is indicated in patients with worsening acidosis or hypoxemia.

3 Things that improve the health and quality of life of people with COPD and help keep them out of hospital are:

1. Integrated disease management.

2. Inhaled long - acting beta 2-agonists(LABAS)

3. Tiotropium (a long-acting bronchodilator).

Exacerbations of chromic obstructive pulmonary disease (COPD) are one of the commonest causes of hospital admission.These adverse events have a large effect on the health status of the patients and impose a heavy burden on healthcare systems.

Interventions to reduce readmissions may need to expand beyond this single focus regarding COPD - specific treatments to also include improvements in patient education,behaviour modification through health coaching, and facilitation of prompt access to outpatient healthcare expertise when needed to impact overall health.

Also COPD care programme can reduce readmissions and in-patient bed days.Some of them are:

• The COPD education sessions conducted in nurse clinics.
• Respiratory nurses made telephone calls to patients at week 4,8,12 and 14 following hospital discharge.
• Patient were offered out-patient physiotherapy training sessions and training on home exercise would be provided.