Readmission Prevention of COPD Patients.

Quality Improvement Problem: The incidence of a COPD patient experiencing hospital readmission reflects on the efficiency of the discharge plan and the provided education during the prior admission. Effective in 2012, The Center for Medicare and Medicaid Services began imposing financial penalties on facilities with excessive readmissions (Lau, Siracuse, & Chamberlain, 2017).

Data to support QI Problem: COPD patients within then US account for: 700,000 hospitalizations annually (Lau et al., 2017). 20 % hospital readmission rates (Pruitt, 2018). Third leading cause of death Annual treatment costs exceed $30 million 1.5 million emergency room visits (Shah, Press, Scheetz & White, 2016). 15 million diagnosed with the disease (Shah et al., 2016). 86% of patients do not use inhalers correctly. Hospital penalties for 2017 reached $528 million (American Hospital Association, 2017)

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Literature to support QI Problem: Hospital readmissions are costly and place a strain on medical resources (Lau et al.,2017). Facilities that exceed the national average in readmissions for COPD patients will be penalized with a reduction of reimbursement from Medicare and Medicaid (American Hospital Association, 2017).

Action Plan: Registered nurse patient care navigator will provide additional teaching to the patient and family. Respiratory therapist will assess patient for proper use of inhalers and nebulizer. Include pharmacist in multidisciplinary rounds to assist with medication management of COPD. Physical therapy will eval and treat to improve exercise capacity and muscle function aimed to decrease fatigue and shortness of breath. Transition of care by ordering home health and telemonitoring at discharge. Bedside medication delivery before discharge to assist with compliance. Scheduling of follow up before discharge

Resources to Support the Action Plan: Creation of patient navigator role. Smoking cessation resources. Daily multidisciplinary patient rounds. Weekly meeting to discuss progress. Publix pharmacy contract for delivery of patient discharge medications.

Resources

American Hospital Association. (2017). AHA fact sheet: hospital readmissions reduction

program | AHA. Retrieved May 12, 2018, from https://www.aha.org/other-

resources/2016-01-18-aha-fact-sheet-hospital-readmissions-reduction-program

Lau, C. S., Siracuse, B. L., & Chamberlain, R. S. (2017). Readmission after COPD exacerbation

scale: determining 30-day readmission risk for COPD patients. International Journal Of

Chronic Obstructive Pulmonary Disease, 121891-1902. doi:10.2147/COPD.S136768

Pruitt, B. (2018). Preventing COPD readmissions: factors that influence success: many factors

have been shown to affect 30-day COPD readmissions and some hospitals have shown

success in reducing their rates. RT: The Journal for Respiratory Care

Shah, T., Press, V. G., Huisingh-Scheetz, M., & White, S. R. (2016). COPD readmissions:

addressing COPD in the era of value-based health care. Chest, 150(4), 916-926.

doi:10.1016/j.chest.2016.05.002

Readmission Prevention of COPD Patients.