Spreading improvements for advanced COPD care through a Canadian Collaborative.

Area of Science:

• Healthcare Quality Improvement
• Chronic Obstructive Pulmonary Disease (COPD) Management
• Public Health Interventions

Background:

• A pan-Canadian quality improvement collaborative (QIC) facilitated the spread of the INSPIRED COPD Outreach Program™.
• The program was adapted and implemented by 19 teams across 10 Canadian provinces.
• This study evaluates the QIC's success in replicating the model and the teams' implementation strategies.

Purpose of the Study:

• To assess the replicability of the Nova Scotia-based INSPIRED COPD Outreach Program™ model in diverse Canadian settings.
• To understand how various teams implemented and evaluated their adapted versions of the INSPIRED program.
• To identify key factors contributing to successful COPD care improvement.

Main Methods:

• A mixed-methods approach was used to evaluate the complex intervention.
• Collaborative faculty selected evidence-based process and outcome measures across four quality domains: patient-centeredness, coordination, efficiency, and appropriateness.
• Data collection involved patient surveys, interviews, and validated measures like the Care Transitions Measure (CTM-3) and Lung Information Needs Questionnaire (LINQ).

Main Results:

• Fifteen teams implemented all core INSPIRED interventions, with 13 actively involving patients in care planning.
• Patients reported enhanced self-confidence in symptom management, improved quality of life, and a return to daily activities.
• Two detailed case studies showed substantial reductions in hospital admissions, emergency room visits, and patient-related costs.

Conclusions:

• Quality-of-care improvements for advanced COPD are achievable in the short term across diverse contexts.
• A well-funded public-private partnership can effectively disseminate beneficial COPD care models.
• The INSPIRED COPD Outreach Program™ demonstrates a scalable and impactful approach to improving COPD patient outcomes and healthcare system efficiency.