A23-04 The Reduce Revisits Study: Site-Level Assessment of Sustainability Confidence for COPD Transition of Care Interventions

Abstract Rationale Chronic Obstructive Pulmonary Disease (COPD) affects over 16 million U.S. adults and is associated with high rates of emergency department and hospital revisits following COPD-related hospitalizations. These frequent exacerbations, often linked to breakdowns during transitions of care (TOC), contribute to lung function decline and early mortality. Although effective interventions exist to reduce readmissions, large-scale implementation of COPD TOC programs remains limited. The NIH-funded R01 study, Reduce REVISITS, was designed to close this gap by implementing bundled TOC programs across 20 U.S. hospitals. Following the year-long implementation phase, site leads completed a post-implementation survey, followed by a contextual assessment, to quantify site-level confidence in sustaining these interventions. Methods Site leads completed a post-implementation sustainability survey rating their confidence that each of three bundled TOC interventions would be sustained 12 months after implementation. Responses were recorded on a 5-point Likert scale (Strongly Disagree = -2 to Strongly Agree = +2). Individual intervention scores were totaled to produce a “bundle sustainability score” ranging from -6 to + 6 per site. Descriptive analyses summarized mean and range of scores across sites. Results All 20 sites provided complete survey responses from one or two site leads. Mean sustainability confidence scores across interventions were +1.3 for Intervention 1, +1.0 for Intervention 2, and +0.9 for Intervention 3. Composite bundle intervention scores ranged from 0 to + 6 (possible range -6 to + 6; mean = +3.2, SD = 1.6), indicating overall moderate confidence in sustaining COPD TOC interventions one-year post-implementation. Fourteen sites (70%) scored ≥3, reflecting optimism about long-term sustainability, while three sites (15%) scored ≤1, citing ongoing staffing or workflow challenges during contextual assessments. Conclusion Survey results suggest most enrolled hospitals are confident their COPD TOC interventions will be sustained over the next year. Variation across sites highlights the influence of local factors, such as staffing capacity and workflow integration, on sustainability. Future work will link these quantitative sustainability scores with qualitative contextual assessments to identify predictors of long-term implementation success. This abstract is funded by: NIH