Learning from the national projects
Over the past year twelve project sites have undertaken project work that aimed to improve acute care for people with an exacerbation of COPD. The emerging learning from these projects will be available to download from this website shortly.
At this mid-point of their work the project teams have identified issues, challenges,some solutions and some additional questions. Whilst there may not be answers to all the issues at this point there are some common themes that identify priorities for further work or that can guide other teams in determining how to progress their own work. The key themes that emerged were:
Pre-hospital care
Hospital at Home schemes can provide a safe and effective alternative to hospital admission for some people with acute exacerbation of COPD. A case management approach for people with COPD who frequently attend the Emergency Department may be an effective way to reduce unnecessary secondary care service use in this cohort.
Admission processes
Too many routes into and too many pathways through the hospital leads to variation in the quality of care experienced by a patient.
Referral mechanisms
A lack of clear and effective referral mechanisms for specialist care leads to increased variation in quality of care waste of resources as clinical time is spent ‘looking’ for patients.
Specialist care
Early referral for specialist care during the in-patient stay may reduce length of hospital stay
Communication within organisations
Poor communication at patient transfer between wards and departments causes delays and duplication of tests and interventions. Important information may be missed.
Communication between services
Poor communication between primary care, secondary care and community services leads to delays and ‘gaps’ in service provision at all stages of the patient pathway Service awareness – within and between organisations there is a lack of awareness by clinicians of the services that are available for the COPD patients leading to opportunities for high quality care being missed.
Developing an integrated acute care pathway for COPD is an important step in improving these processes, increasing the quality of clinical care and transforming the patient’s experience of care during an exacerbation of COPD.
By addressing these challenges we want to:
- Reduce avoidable admissions and readmissions by increasing integrated care and supported self management
- streamlining in-patient care for example through the implementation of care bundles, and the widespread availability of high quality specialist care
- Integrate patient focused post-exacerbation follow-up into long term condition management
More information
For more information about transforming acute care, please contact:
Catherine Thompson
National Improvement Lead
Lung Improvement Programme
NHS Improvement
Mobile: 0782 514 2815
Email: catherine.thompson@improvement.nhs.uk