Moira Kendra1, Rupal Mansukhani2,3, Nicole Rudawsky4,5, Lisa Landry4, Natalie Reyes4, Stephanie Chiu6, Brittney Daley4, Daniel Markley7, Brandee Fetherman1, Edward A Dimitry7, Federico Cerrone7, Chirag V Shah7. 1. Atlantic Health System, Morristown, NJ, USA. 2. Morristown Medical Center, Morristown, NJ, USA. Rupal.mansukhani@atlantichealth.org. 3. Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA. Rupal.mansukhani@atlantichealth.org. 4. Morristown Medical Center, Morristown, NJ, USA. 5. Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA. 6. Atlantic Center for Research, Morristown, NJ, USA. 7. Atlantic Medical Group, Morristown, NJ, USA.
Abstract
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a chronic condition that leads to significant morbidity and mortality. Management of COPD hospitalizations utilizing an evidence-based care bundle can provide consistent quality of care and may reduce readmissions. METHODS: This single-center retrospective cohort study evaluated readmission rates in patients hospitalized with a COPD exacerbation. Patients in the pre-intervention cohort received usual care, while patients in the post-intervention cohort received an innovative inpatient COPD care bundle. The bundle focused on optimizing care in five areas: consults, inpatient interventions, education, transitions of care, and after discharge care. RESULTS: In this study, 149 subjects were included in the pre-intervention cohort and 214 subjects were included in the post-intervention cohort. Thirty-day readmission rates were lower in the post-intervention cohort compared to the pre-intervention cohort, 22.4% vs. 38.3% (p = 0.001). A reduction in 60-day and 90-day readmission rates was also observed, 13.7% vs. 40.3% (p < 0.001) and 10.1% vs. 32.2% (p < 0.001), respectively. CONCLUSION: Bundled care is an effective and inexpensive method for institutions to provide consistent and quality care. The findings of this study demonstrate that the implementation of a COPD care bundle is an effective strategy to decrease hospital readmissions.
PURPOSE: Chronic obstructive pulmonary disease (COPD) is a chronic condition that leads to significant morbidity and mortality. Management of COPD hospitalizations utilizing an evidence-based care bundle can provide consistent quality of care and may reduce readmissions. METHODS: This single-center retrospective cohort study evaluated readmission rates in patients hospitalized with a COPD exacerbation. Patients in the pre-intervention cohort received usual care, while patients in the post-intervention cohort received an innovative inpatient COPD care bundle. The bundle focused on optimizing care in five areas: consults, inpatient interventions, education, transitions of care, and after discharge care. RESULTS: In this study, 149 subjects were included in the pre-intervention cohort and 214 subjects were included in the post-intervention cohort. Thirty-day readmission rates were lower in the post-intervention cohort compared to the pre-intervention cohort, 22.4% vs. 38.3% (p = 0.001). A reduction in 60-day and 90-day readmission rates was also observed, 13.7% vs. 40.3% (p < 0.001) and 10.1% vs. 32.2% (p < 0.001), respectively. CONCLUSION: Bundled care is an effective and inexpensive method for institutions to provide consistent and quality care. The findings of this study demonstrate that the implementation of a COPD care bundle is an effective strategy to decrease hospital readmissions.
Authors: César de Andrade de Lima; Regina Celia de Oliveira; Simone Andrade Gonçalves de Oliveira; Mônica Alice Santos da Silva; Alcione de Andrade Lima; Maria Sandra Andrade; Clarissa Mourão Pinho Journal: Rev Bras Enferm Date: 2020-07-10
Authors: Ruben D Restrepo; Melissa T Alvarez; Leonard D Wittnebel; Helen Sorenson; Richard Wettstein; David L Vines; Jennifer Sikkema-Ortiz; Donna D Gardner; Robert L Wilkins Journal: Int J Chron Obstruct Pulmon Dis Date: 2008
Authors: Valerie G Press; David H Au; Jean Bourbeau; Mark T Dransfield; Andrea S Gershon; Jerry A Krishnan; Richard A Mularski; Frank C Sciurba; Jamie Sullivan; Laura C Feemster Journal: Ann Am Thorac Soc Date: 2019-02