Learning from national projects
Emerging learning from the national improvement projects on long term and self management of COPD will shortly be published in full. Ten sites have been working on projects that have ranged from understanding current levels of care provision to delivery of self management action plans for COPD patients.
At this mid point of their work, the project teams have identified issues, challenges, some solutions and some additional questions. While there may not be answers to all the issues at this point, there are some common themes that identify priorities for further work or can guide other teams in determining how to progress their own work. These include:
Effective self management
Patient self management is dependent on a range of factors, including motivation, knowledge, resources, time and skills, as well as information contained in a written self management plan. The key is not the plan you use but the planning you do with the patient.
More information about the importance of self management
What does a good review look like?
Approaches to patient review are largely based on the clinical priorities and structured care, which can be supported by the use of templates. However, more work is needed to identify what constitutes a good and effective review from the patients’ perspective, and what skills and resources are necessary.
Optimising medicines use
Inhaler technique is very often poor amongst staff and patients, but can be improved with the use of devices like the In-Check Dial or 2Tone trainer.
Rescue medication can be valuable in improving management of exacerbations, but people need to understand what their medication is for and when to use it, so this needs to be explained carefully. This can be reinforced with clear labelling.
Using data to make a difference
Coding consistently is essential. Identifying exacerbations of COPD means you can pick up patients who are beginning to deteriorate and you can also see how well you are managing their exacerbations.
If you have access to and use appropriate information you can target:
- high users of services – to reduce urgent care use
- newly diagnosed patients – to reduce readmissions
- moderate patients – who may account for a high number of admissions
You can also identify the total use of primary care time, urgent care and secondary care for patients to ascertain the impact of effective management.
See our guide to data for lung improvement projects for more information on where to find the data you need and how to use it in a meaningful way.
The projects will also be exploring over the next six months:
- how to manage longer reviews and support self management within existing resources
- the impact of optimising care and medications use on cost and resource use
- what constitutes an effective review from the patient perspective?
- what are the key components that need to be in place for patients to be able to effectively self manage?
More information:
For more information on this workstream contact:
Catherine Blackaby
National Improvement Lead
Lung Improvement Programme
NHS Improvement
Mobile: 0782 519 3616
Email: catherine.blackaby@improvement.nhs.uk