What is COPD?
Chronic obstructive pulmonary disease (COPD) is a condition that affects all parts of the lung through that mainly affects middle-age and older adults who smoke. While the British Lung Foundation (BLF) estimated that COPD is the second most common lung disease, many do not realise that they have the condition (BLF 2019).
The symptoms of COPD include breathlessness, a persistent chesty cough and/or wheezing, and reoccurring chest infections. These symptoms often become worse over time, especially when the person is being active and while the impact of COPD can vary, its effects can be felt every day. In particular, during periods of stress or bacterial or viral infections, the effects of COPD can suddenly worsen (known as an “acute exacerbation”) and can result in unplanned hospital admissions.
Improving COPD care
Recognising the impact of respiratory illnesses on the UK population, the NHS Long Term Plan (NHS England 2019) includes a focus on respiratory diseases such as COPD to help clinicians focus on improving outcomes for those with the condition.
This includes work on improving existing pathways of care, such as the use of the British Thoracic Society (BTS) COPD discharge bundle which forma a list of elements that if undertaken, help reduce readmissions for patients admitted with acute exacerbations of COPD.
The elements of the full care bundle are:
1. Inhaler technique assessed with the patient prior to discharge
2. a) Provision of written information on discharge
b).Provision of medication rescue packs on discharge
3. Patient assessed and offer referral to stop smoking services if a current smoker
4. Patient assessed for suitability for enrolment into a pulmonary rehabilitation programme
5. Appropriate post discharge follow up arranged
In 2014, the Kent, Surrey and Sussex (KSS) Academic Health Sciences Network (AHSN) team undertook a Respiratory Programme which included the development of a local COPD discharge bundle programme. This approach involved working closely with local COPD teams to review their use of the BTS COPD discharge bundle and support the teams to develop their discharge processes further. As part of this work, the KSS team also created a dashboard to provide quarterly data reports on which elements of the discharge bundle teams were able to deliver. This dashboard was made available to the local teams so they could use this data to inform and develop their discharge services as needed.
The Wessex COPD discharge bundle project
The positive impact the KSS AHSN COPD discharge
bundle programme had, has led to the approach being adopted by all 15 AHSN’s across
In Wessex, the Patient Safety team has shared the COPD discharge bundle dashboard with local COPD teams to allow them to identify how the bundle is being used and where developments in practice might improve patient care. The Wessex Patient Safety team are supporting the use of the dashboard offering quality improvement support and providing opportunities for COPD teams to collaborate across the region to promote shared learning. This approach hopes to improve patient experiences by supporting local teams to use the COPD discharge bundle.
UPDATE: 29 April 2020
Due to the Covid-19 pandemic, this project is currently suspended. During this time, we recommend COPD teams access the British Thoracic Society's SPACES (Sharing Patient Assessments Cuts Exposure for Staff) and the AHSN COPD support pages for relevant respiratory resources.
As the Wessex Patient Safety team recognises that it is especially important to keep COPD patients well at the moment, we are therefore keen to offer our support to our COPD teams where we are able to. Therefore, if you work within any of the Wessex COPD teams and feel that there are ways that the Wessex Patient Safety team could appropriately continue to support you, please contact the Programme Co-ordinator by the link below.