What question did this study set out to answer?

The aim is to enhance COPD care by integrating education and resources in the inpatient care pathway to reduce readmissions.

March 14, 2026

Benefits of Including RT Education and a Take Home Kit as Part of Your Inpatient COPD Care Pathway

Key Result

Implementing a COPD order set with education and a take-home kit reduced readmission rates to 12.50% by Fiscal Year 2026, down from 16.23%-17.58% from FY22-24.

Key Points

The aim is to enhance COPD care by integrating education and resources in the inpatient care pathway to reduce readmissions.
Review of 6 quality studies to identify gaps in COPD care practices.
Development of a care bundle including bedside education and a take-home kit for patients.
Assessment of inhaler technique using AIM before and after implementation of the new care bundle.
10% increase in order set utilization from FY22 to FY24-March.
50% of patients received COPD education through the order set.
Readmission rates dropped significantly, projecting no penalties from CMS in FFY25 and FFY26.

Structured PICO

Does a COPD order set with RT education and a take-home kit reduce 30-day readmissions in hospitalized COPD patients?

Population

Hospitalized patients with COPD exacerbation

Intervention

COPD order set including bedside respiratory therapist education and a take-home kit (albuterol, portable pocket nebulizer, COPD action plan, and handbook)

Comparator

Historical standard of care (prior COPD order set without the novel education and take-home kit)

Outcome

30-day readmission rateshard clinical

Adding bedside respiratory therapist education and a take-home kit to a COPD order set may improve utilization and reduce 30-day readmissions.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: CMS Hospital Readmissions Reduction Program aims to reduce 30-d readmissions by encouraging hospitals to improve care coordination and communication between patients and care givers. Evidence has shown that COPD care bundles may be beneficial in reducing length of stay (LOS) and/or readmissions for a COPD exacerbation1. An interdisciplinary workgroup was created to research best practices and develop a new care bundle. A COPD order set had already been in place at this organization for several years. However, utilization was low at 31.68% (FY21) and in need of some improvements. Additionally, after a review of the literature it was identified key items were missing from our original order set that might be of benefit. Methods: A review was conducted of 6 studies that met certain criteria (quality, value, and ethical principles)2. An interdisciplinary workgroup had identified some gaps for patients that were being discharged with traditional inhalers. Issues included delays in receiving medication, drug cost, and failure to use proper technique. Studies have shown a high rate of inhaler misuse among hospitalized patients. Patients had their technique tested using AIM (Aerosol Inhaler Monitor) 58%, 52%, and 38% failed to use proper technique at the first, second, and third test, respectively3. So, in addition to standard order set items like O2, meds, ABG, etc, a novel concept was added to our orders to provide bedside education and a take-home kit. The free kit includes: albuterol, portable pocket neb, a COPD action plan and handbook. After several iterations of trial and error, a consistent process was implemented in April, 2023 by utilizing the outpatient pulmonary rehab therapist. Results: With increased focus on order set utilization, a 10% increase occurred by (FY24-March). Use of the order set helped ensure that COPD education was provided to 50% of the COPD order set group, with 39% receiving a take home kit. COPD payment reductions were issued by CMS for FFY22-24 for higher-than-expected readmission rates (16.23%-17.58%). Our CMS FFY25 and FFY26 (3 years of data) are projecting no payment reductions as rates have dropped to as low as 12.50%. Conclusions: Order set utilization is an important foundation to reducing LOS and readmissions for patients with COPD. Education, proper medication delivery technique, and a take home kit which includes a 30-d supply of medication are important items to consider adding to a COPD order set and may help to reduce COPD readmissions.Order Set UtilizationFiscal YearOrder Set UtilizationFY2242%*FY2353%FY24-March51.43%*These numbers were annualized due to incomplete year of reportingReadmissionsReporting YearReadmission RatesPenaltyFFY22-2416.23%-17.58%YesFFY2516.28%Maybe NoFFY2612.50%Projected No*CMS REPORTING: FFY is reflective of 3 fiscal years prior data. FFY25(7/1/20-6/30/23) & FFY26(7/1/21-6/30/24)

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