Evaluation of an implementation package to deliver the COPD CARE service
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is estimated to be the leading cause of death in the next 15 years. Patients with COPD suffer from persistent chronic cough, sputum production and exacerbations leading to deteriorating lung function, wors...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/12/1/e002074.full |
| _version_ | 1811162873645236224 |
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| author | Michelle A Chui Jen Birstler David Goodrich Edward Portillo Molly Lehmann Timothy Hagen Martha Maurer Jordyn Kettner Sonia Bhardwaj M Shawn McFarland Natasha Virrueta Blake Henderson |
| author_facet | Michelle A Chui Jen Birstler David Goodrich Edward Portillo Molly Lehmann Timothy Hagen Martha Maurer Jordyn Kettner Sonia Bhardwaj M Shawn McFarland Natasha Virrueta Blake Henderson |
| author_sort | Michelle A Chui |
| collection | DOAJ |
| description | Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is estimated to be the leading cause of death in the next 15 years. Patients with COPD suffer from persistent chronic cough, sputum production and exacerbations leading to deteriorating lung function, worsening quality of life and loss of independence. While evidence-based interventions exist to improve the well-being of patients with COPD, incorporation of these interventions into routine clinical care is challenging. Chronic Obstructive Pulmonary Disease Coordinated Access to Reduce Exacerbations (COPD CARE) is a team-based, coordinated care transitions service integrating evidence-based interventions for COPD management within the patient care delivery model to reduce readmissions. This evaluation considers the process of scaling the COPD CARE service across medical facilities using an implementation package designed for service expansion. The implementation package was developed at the United States Veterans Health Administration and implemented at two medical centres. Core dissemination and implementation science methods were applied to guide design and delivery of the implementation package.The aims of this evaluation were to (1) evaluate the impact of the implementation package on use of evidence-based interventions for COPD management and (2) explore clinician perceptions of the implementation package. This prospective mixed-methods quality improvement project included two Plan Do Check Act (PDCA) cycles conducted over a 24-month period. Electronic health record data demonstrated significant improvements in the count of evidence-based interventions incorporated into routine clinical care after training completion (p<0.001), offering preliminary effectiveness of the package to improve uptake of best practices for COPD management. Clinician perceptions of the implementation package, measured by questionnaire at multiple time points, demonstrated significant improvements for all scales at the end of the final PDCA cycle. Clinicians described the implementation package as positively impacting clinician confidence, interprofessional collaboration and patient care delivery. |
| first_indexed | 2024-04-10T06:36:18Z |
| format | Article |
| id | doaj.art-68908462ba1f4c0e97e2107e554c89a6 |
| institution | Directory Open Access Journal |
| issn | 2399-6641 |
| language | English |
| last_indexed | 2024-04-10T06:36:18Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj.art-68908462ba1f4c0e97e2107e554c89a62023-02-28T20:30:11ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-02-0112110.1136/bmjoq-2022-002074Evaluation of an implementation package to deliver the COPD CARE serviceMichelle A Chui0Jen Birstler1David Goodrich2Edward Portillo3Molly Lehmann4Timothy Hagen5Martha Maurer6Jordyn Kettner7Sonia Bhardwaj8M Shawn McFarland9Natasha Virrueta10Blake Henderson11University of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin, USAUniversity of Wisconsin-Madison, Institute for Clinical and Translational Research (ICTR), Madison, Wisconsin, USADepartment of Veterans Affairs, Center for Health Equity and Promotion (CHERP), Pittsburgh, Pennsylvania, USAUniversity of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin, USADepartment of Veterans Affairs, William S. Middleton VA Hospital, Madison, Wisconsin, USADepartment of Veterans Affairs, Healthcare System of the Ozarks, Fayetteville, Arkansas, USAUniversity of Wisconsin-Madison, School of Pharmacy, Madison, Wisconsin, USADepartment of Veterans Affairs, William S. Middleton VA Hospital, Madison, Wisconsin, USADepartment of Veterans Affairs, William S. Middleton VA Hospital, Madison, Wisconsin, USADepartment of Veterans Affairs, Clinical Pharmacy Practice Office, Washington, DC, USADepartment of Veterans Affairs, William S. Middleton VA Hospital, Madison, Wisconsin, USADepartment of Veterans Affairs, Diffusion of Excellence, Washington, DC, USAChronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide and is estimated to be the leading cause of death in the next 15 years. Patients with COPD suffer from persistent chronic cough, sputum production and exacerbations leading to deteriorating lung function, worsening quality of life and loss of independence. While evidence-based interventions exist to improve the well-being of patients with COPD, incorporation of these interventions into routine clinical care is challenging. Chronic Obstructive Pulmonary Disease Coordinated Access to Reduce Exacerbations (COPD CARE) is a team-based, coordinated care transitions service integrating evidence-based interventions for COPD management within the patient care delivery model to reduce readmissions. This evaluation considers the process of scaling the COPD CARE service across medical facilities using an implementation package designed for service expansion. The implementation package was developed at the United States Veterans Health Administration and implemented at two medical centres. Core dissemination and implementation science methods were applied to guide design and delivery of the implementation package.The aims of this evaluation were to (1) evaluate the impact of the implementation package on use of evidence-based interventions for COPD management and (2) explore clinician perceptions of the implementation package. This prospective mixed-methods quality improvement project included two Plan Do Check Act (PDCA) cycles conducted over a 24-month period. Electronic health record data demonstrated significant improvements in the count of evidence-based interventions incorporated into routine clinical care after training completion (p<0.001), offering preliminary effectiveness of the package to improve uptake of best practices for COPD management. Clinician perceptions of the implementation package, measured by questionnaire at multiple time points, demonstrated significant improvements for all scales at the end of the final PDCA cycle. Clinicians described the implementation package as positively impacting clinician confidence, interprofessional collaboration and patient care delivery.https://bmjopenquality.bmj.com/content/12/1/e002074.full |
| spellingShingle | Michelle A Chui Jen Birstler David Goodrich Edward Portillo Molly Lehmann Timothy Hagen Martha Maurer Jordyn Kettner Sonia Bhardwaj M Shawn McFarland Natasha Virrueta Blake Henderson Evaluation of an implementation package to deliver the COPD CARE service BMJ Open Quality |
| title | Evaluation of an implementation package to deliver the COPD CARE service |
| title_full | Evaluation of an implementation package to deliver the COPD CARE service |
| title_fullStr | Evaluation of an implementation package to deliver the COPD CARE service |
| title_full_unstemmed | Evaluation of an implementation package to deliver the COPD CARE service |
| title_short | Evaluation of an implementation package to deliver the COPD CARE service |
| title_sort | evaluation of an implementation package to deliver the copd care service |
| url | https://bmjopenquality.bmj.com/content/12/1/e002074.full |
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