Breakout 1.3 The Implementation of a COPD Discharge Care Bundle: Why, How and Who? - Louise Sewell Clinical Lead for Pulmonary Rehabilitation & COPD Nurse Specialists Services - University Hospitals of Leicester Part of a set of presentations from NHS Improvement event: Better value, better outcomes held on Thursday 21 February 2013, Guoman Tower Hotel, London How to deliver quality and value in chronic care:sharing the learning from the respiratory programme

1. The Implementation of a
COPD Discharge Care Bundle:
Why, How and Who?
Louise Sewell
Clinical Lead for Pulmonary Rehabilitation
& COPD Nurse Specialists Services
Why? Who?
When? How?
1

2. Why?
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3. Why?
UHL Local CQUIN COPD
2012-13 Care
Bundle
Care bundle
Who?
• 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
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4. When?
Operational phase
Implementation phase
Sept 2011 Jan 2012 Feb 2012 April 2012 May ’12-Mar 13
•Set up task & •Contents of •REDS team •REDS team •COPD
finish group – bundle agreed begin to pilot deliver transformational
meet regularly to bundle
•Changes to bundle to all funding
discuss process,
REDS team their patients
paperwork and •6 and 9 month
implementation management • Local data analysis
•Staff SPACE £960000
training begins CQUIN
commences
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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?
160
137
140
# pts received care bundle
127
120 105
99
90 92 93
100 85 78
80
60 49
40
20 10
0
r
r
st
r
ch
r
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ay
ril
ly
y
be
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be
be
ar
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ar
M
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nu
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em
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pt
De
No
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Total to date = 965
5

6. REDS Care Bundle Data:
Number of phone calls received per patient
70
60
50
40
%
30
20
10
0
0 1 2 3 4 5 6 7 8 9 10
# phone calls per patient
Q1 Q2 Q3
COPD Care Bundle Data:
Smoking Status
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7. COPD Care Bundle Data:
Referrals to smoking cessation services
COPD Care Bundle Data:
Referral to Pulmonary Rehabilitation
100%
80%
60%
missing data
40% not appropriate
58 62 declined
51 53 46 73
53
20% completed
28
6
0%
r
st
No ber
De ber
Oc r
ne
ay
ril
ly
be
be
gu
Ju
Ap
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Ju
m
em
to
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Au
ce
ve
pt
Se
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8. Mean number of Pulmonary
Rehabilitation referrals per month
120 104
100
referrals (n)
80 64 69
60
40
20
0
2010-2011 2011-2012 2012-2013
COPD Care Bundle Data:
Length of Stay
2011-12 2012-13
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9. COPD Care Bundle:
patient feedback.
“The information is very “I’m grateful for the support
good and well written but and I’m going through the
I feel it should have been SPACE manual with a fine
done years ago as I feel tooth comb, very helpful.”
it’s too late for me but will Mrs M, aged 61
benefit lots of other
younger people with my
condition.”
Mr S, aged 82
“I think the service is
really helpful and the
“I think the service you
SPACE book is
provide is marvellous, I have
excellent…I have bought
learnt so much from my
some weights and am
admission and feel more
using them three times a
confident with the
week as it tells you to in
management of my COPD.”
the book.”
Mr C, aged 74
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.
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10. Thanks…
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