A Multidisciplinary Intervention to Improve Care for High-Risk COPD Patients

Area of Science:

• Pulmonary Medicine
• Healthcare Quality Improvement
• Patient Management

Background:

• Chronic obstructive pulmonary disease (COPD) exacerbations significantly increase healthcare costs and patient morbidity.
• Effective management strategies are needed to improve care for high-risk COPD patients during acute exacerbations.

Purpose of the Study:

• To design and implement a quality improvement project aimed at enhancing care for high-risk COPD patients hospitalized with an exacerbation.
• To evaluate the impact of a multidisciplinary intervention on patient outcomes and healthcare utilization.

Main Methods:

• An electronic medical record report identified high-risk COPD patients for a targeted intervention.
• Intervention components included pulmonary/respiratory therapy consults, patient navigator phone calls, palliative care referrals, and bedside medication delivery.
• A control group at a partner hospital received usual care over 16 months, enrolling 157 patients.

Main Results:

• The intervention group showed increased referrals to palliative care services.
• Rates of outpatient follow-up improved in the intervention group compared to the control group.
• No significant differences were observed in readmission rates or emergency department visits between the two groups.

Conclusions:

• The quality improvement project successfully increased palliative care referrals and outpatient follow-up for high-risk COPD exacerbation patients.
• Further interventions focusing on outpatient care coordination and addressing psychosocial burdens may be beneficial.
• Current interventions did not significantly impact hospital readmissions or emergency department utilization.