Chronic Obstructive Pulmonary Disease (COPD) Acute Care Collaborative

The Chronic Obstructive Pulmonary Disease (COPD) acute care collaborative helped Victorian health services improve care for people admitted to hospital with COPD.

Delivered in partnership with Lung Foundation Australia, the project supported 10 participating health services to test and embed practical, evidence-based improvements. Nurse ambassadors led the work locally, helping teams improve diagnosis, treatment, referrals and support for people with COPD before they left hospital.

Background

COPD is a progressive lung disease that can make it hard to breathe. It includes conditions such as emphysema, chronic bronchitis and chronic asthma.

COPD affects around one in seven Australians aged over 40, and the leading cause of avoidable hospital admissions. It is often under-recognised and under-diagnosed, meaning many people live with symptoms without getting the care and support they need.

Early signs of COPD can be mistaken for ageing, low fitness or asthma. Improving diagnosis and using evidence-based care can help people manage their condition, reduce hospital readmissions and improve quality of life.

Objectives

Lung Foundation Australia and 10 participating public health services explored ways to better use evidence-based care for people admitted to hospital with COPD.

The project developed and tested tools, resources and local supports to:

• improve accurate diagnosis using spirometry
• increase referrals to pulmonary rehabilitation
• improve assessment of inhaler technique and adherence
• support evidence-based prescribing for COPD exacerbations
• help people with COPD and their and carers recognise and manage COPD exacerbations
• support timely review after hospitalisation.

Outcomes

The collaborative supported 127 people with COPD through simple but important changes to hospital care. These included checking inhaler technique, improving symptom management and supporting people to manage their condition at home.

The project also helped build improvement capability across participating services. Nurse ambassadors supported local teams to embed best practice care, and clinicians reported greater confidence leading change beyond this project.

Key results

• Readmission rates fell by 34%.
• The proportion of admitted patients who had their inhaler technique assessed before discharge increased by 84%.
• The proportion of admitted patients with spirometry results confirming their diagnosis increased by 3.4%.
• COPD action plan completion before discharge increased by 74%.
• Pulmonary rehabilitation referrals after discharge increased by 20%.
• The project informed the COPD Acute Care Quality Improvement Toolkit developed by Lung Foundation Australia, helping translate national best practice into practical steps for clinical teams.

‘… greater uptake of COPD action plans has empowered patients to better manage exacerbations, reducing hospital admissions … the increased documentation of spirometry results has improved diagnostic accuracy and monitoring, allowing for timely and personalised treatment.’

– Regional nurse ambassador

Next steps

SCV will apply learnings from this project to related improvement work, including the Virtual Pulmonary Rehabilitation Pilot and the Assisted Self-Management Pilot.

Resources

Poster