Key result
Implementation of a multidisciplinary, 5-element COPD care bundle reduced COPD readmission rates from 22.7% prior to implementation to 14.7% over a 6-month period.
Why the study?
COPD drives high hospitalization and readmission rates, and identifying an effective strategy for health systems to reduce readmissions has remained difficult.
Does a multidisciplinary, 5-element COPD care bundle involving pharmacists reduce hospital readmission rates in patients with COPD?
Does a multidisciplinary, 5-element COPD care bundle involving pharmacists reduce hospital readmission rates in patients with COPD?
Absolute Event Rate: 14.7% vs 22.7%
Implementation of a multidisciplinary COPD care bundle involving pharmacists successfully reduced hospital readmission rates in an urban safety-net hospital.
May support COPD care bundles to lower readmissions; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major contributor of morbidity and mortality in the United States resulting in high hospitalization and readmission rates. For health systems, identifying an effective strategy to reduce COPD readmissions has remained difficult. Multiple COPD care bundles have been developed with varying degrees of success. Bundles that were multidisciplinary and included pharmacists were successful in reducing readmissions. OBJECTIVE: To describe and assess a multidisciplinary, 5-element, COPD care bundle that was implemented in an academic, urban safety-net hospital to reduce COPD readmissions and the role of pharmacists in bundle implementation. METHODS: A multidisciplinary team collaborated to develop a 5-element COPD care bundle that met unmet patient needs. The bundle elements included the following, with pharmacy responsible for the first two: optimization of COPD inhalers, 30-day supply of insurance-compatible inhalers, individualized patient inhaler teaching, provision of standardized discharge instructions, and scheduling of a 15-day discharge follow-up appointment. Bundle was implemented with multiple Plan-Do-Study-Act (PDSA) cycles to develop intra- and interdepartment processes. RESULTS: Prior to bundle implementation, the health system COPD readmission rates were 22.7%. Reliable implementation of the bundle reduced readmissions to 14.7% over a 6-month period. Pharmacy adherence to completion of the bundle was over 95% over 2 years of bundle use. CONCLUSION: Pharmacists have a crucial role in hospital-based transitions of care to reduce COPD readmissions.
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Gentene et al. (2019) studied Chronic obstructive pulmonary disease (COPD). Multidisciplinary, 5-element COPD care bundle vs. Pre-implementation (historical control) was evaluated on COPD readmission rates. Implementation of a multidisciplinary, 5-element COPD care bundle reduced COPD readmission rates from 22.7% prior to implementation to 14.7% over a 6-month period.
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