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The Irish national chronic obstructive pulmonary disease quality improvement collaborative: an adaptive learning
Orla Woods1, Rachel MacDonell2, John Brennan2
1Research, Royal College of Physicians of Ireland, Dublin 2, Ireland orla.woods@gmail.com.
BMJ Open Quality
|January 8, 2024
Summary
This quality improvement collaborative improved acute COPD care in Ireland by standardizing treatment and enhancing patient outcomes. The adaptive learning approach empowered hospital teams to implement effective, localized changes for better AECOPD management.
Area of Science:
- Healthcare Quality Improvement
- Pulmonary Medicine
- Health Services Research
Background:
- Acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) are a leading cause of hospital admissions in Ireland.
- Existing AECOPD treatment protocols lack standardization across Irish public hospitals.
Purpose of the Study:
- To design and implement a flexible, adaptive quality improvement (QI) collaborative to standardize and improve AECOPD care.
- To provide QI teaching and support to enable hospital teams to implement bespoke, locally relevant changes.
Main Methods:
- A 13-month collaborative involving 18 teams from 19 Irish hospitals.
- Utilized Institute for Healthcare Improvement methodologies with in-person sessions, site visits, and coaching.
- Collected monthly patient data on 22 AECOPD care measures for evaluation.
Main Results:
- Statistically significant improvements observed in DECAF assessment, documented diagnosis via spirometry, and inhaler technique review.
- Enhanced standardization of 'First respiratory review' processes.
- Participants reported learning QI skills and improving patient care, despite challenges like increased workload.
Conclusions:
- A flexible, adaptive QI collaborative effectively facilitated improvements in AECOPD patient care.
- The collaborative learning model empowered teams to achieve context-specific improvements in their hospitals.
- QI involvement was instrumental in driving positive changes in acute COPD management.
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