COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates
Raj Parikh,1 Trushil G Shah,2 Rajive Tandon2 1Department of Internal Medicine, 2Department of Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, IL, USA Introduction: COPD is the third leading cause of death in the world. Utilizing care bundles during acute COPD exacerb...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-03-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/copd-exacerbation-care-bundle-improves-standard-of-care-length-of-stay-peer-reviewed-article-COPD |
| _version_ | 1818518695494811648 |
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| author | Parikh R Shah TG Tandon R, |
| author_facet | Parikh R Shah TG Tandon R, |
| author_sort | Parikh R |
| collection | DOAJ |
| description | Raj Parikh,1 Trushil G Shah,2 Rajive Tandon2 1Department of Internal Medicine, 2Department of Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, IL, USA Introduction: COPD is the third leading cause of death in the world. Utilizing care bundles during acute COPD exacerbations results in fewer complications and lower costs. Our aim was to construct a COPD exacerbation care bundle and evaluate the effects on patient care. Methods: We conducted a prospective analysis of 44 patients admitted with a COPD exacerbation to a single tertiary care facility. Primary outcomes included length of stay, readmission rates, and hospital costs. Secondary outcomes included patient education, pulmonologist follow-up, and timeliness of medication administration. Two cohorts were analyzed: those treated with an electronic COPD care bundle (cases; N=22) versus those treated without the care bundle (controls; N=22). Results: Mean length of stay (51.2 vs 101.1 hours in controls; P-value =0.001), 30-day readmission rates (9.1% vs 54.4% in controls; P-value =0.001), and 60-day readmission rates (22.7% vs 77% in controls; P-value =0.0003) decreased in the care bundle group. Ninety-day hospital costs had a significant difference in the care bundle group (US$7,652 vs US$19,954 in controls; P-value =0.044). Secondary outcomes included a 100% rate of COPD inhaler teaching (vs 27.3% in controls; P-value <0.001), 59.1% rate of pulmonologist follow-up after discharge (vs 18.2% in controls; P-value =0.005), and a mean reduction in time to steroid administration (7.0 hours; P-value =0.015) seen in the care bundle cases. Conclusion: Our significant findings coupled with the recent success of standardized algorithms in managing COPD exacerbations stress the importance of enforcing clinical guidelines that can enhance patient care. We demonstrated improved care for COPD exacerbation patients during hospitalizations, thereby decreasing morbidity and the financial burden hospitals face in regard to this increasingly prevalent disease. Keywords: acute exacerbation of chronic obstructive lung disease, COPD, care bundle |
| first_indexed | 2024-12-11T01:13:49Z |
| format | Article |
| id | doaj.art-837dcccf63fa42eb9a580ef16108e8ff |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-11T01:13:49Z |
| publishDate | 2016-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-837dcccf63fa42eb9a580ef16108e8ff2022-12-22T01:25:58ZengDove Medical PressInternational Journal of COPD1178-20052016-03-012016Issue 157758326050COPD exacerbation care bundle improves standard of care, length of stay, and readmission ratesParikh RShah TGTandon R,Raj Parikh,1 Trushil G Shah,2 Rajive Tandon2 1Department of Internal Medicine, 2Department of Pulmonary and Critical Care Medicine, Rush University Medical Center, Chicago, IL, USA Introduction: COPD is the third leading cause of death in the world. Utilizing care bundles during acute COPD exacerbations results in fewer complications and lower costs. Our aim was to construct a COPD exacerbation care bundle and evaluate the effects on patient care. Methods: We conducted a prospective analysis of 44 patients admitted with a COPD exacerbation to a single tertiary care facility. Primary outcomes included length of stay, readmission rates, and hospital costs. Secondary outcomes included patient education, pulmonologist follow-up, and timeliness of medication administration. Two cohorts were analyzed: those treated with an electronic COPD care bundle (cases; N=22) versus those treated without the care bundle (controls; N=22). Results: Mean length of stay (51.2 vs 101.1 hours in controls; P-value =0.001), 30-day readmission rates (9.1% vs 54.4% in controls; P-value =0.001), and 60-day readmission rates (22.7% vs 77% in controls; P-value =0.0003) decreased in the care bundle group. Ninety-day hospital costs had a significant difference in the care bundle group (US$7,652 vs US$19,954 in controls; P-value =0.044). Secondary outcomes included a 100% rate of COPD inhaler teaching (vs 27.3% in controls; P-value <0.001), 59.1% rate of pulmonologist follow-up after discharge (vs 18.2% in controls; P-value =0.005), and a mean reduction in time to steroid administration (7.0 hours; P-value =0.015) seen in the care bundle cases. Conclusion: Our significant findings coupled with the recent success of standardized algorithms in managing COPD exacerbations stress the importance of enforcing clinical guidelines that can enhance patient care. We demonstrated improved care for COPD exacerbation patients during hospitalizations, thereby decreasing morbidity and the financial burden hospitals face in regard to this increasingly prevalent disease. Keywords: acute exacerbation of chronic obstructive lung disease, COPD, care bundlehttps://www.dovepress.com/copd-exacerbation-care-bundle-improves-standard-of-care-length-of-stay-peer-reviewed-article-COPDacute exacerbation chronic obstructive lung diseaseCOPDcare bundle |
| spellingShingle | Parikh R Shah TG Tandon R, COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates International Journal of COPD acute exacerbation chronic obstructive lung disease COPD care bundle |
| title | COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates |
| title_full | COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates |
| title_fullStr | COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates |
| title_full_unstemmed | COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates |
| title_short | COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates |
| title_sort | copd exacerbation care bundle improves standard of care length of stay and readmission rates |
| topic | acute exacerbation chronic obstructive lung disease COPD care bundle |
| url | https://www.dovepress.com/copd-exacerbation-care-bundle-improves-standard-of-care-length-of-stay-peer-reviewed-article-COPD |
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