Special Note: Many WHA members proud of their quality improvement efforts had prepared special poster presentations that were to be displayed in the Capitol Rotunda during WHA’s Advocacy Day 2020, which was cancelled due to the COVID-19 pandemic. WHA is pleased to highlight these efforts in today’s and future editions of The Valued Voice.
The Chronic Obstructive Pulmonary Disease (COPD) pathway continues to be successful in reducing COPD 30-day readmissions at Flambeau Hospital. The pathway was rolled out in January of 2018 after having more than 20 COPD readmissions in 2017. In 2018 this number was reduced to three readmissions. The total cost for COPD admissions averages $20,176.35. With reductions in COPD readmissions in 2017, Flambeau hospital achieved an estimated cost reduction of $342,997.89 in 2018.
The pathway follows a patient with COPD mild/moderate or severe symptoms and addresses respiratory treatments, including oxygen use, medications and home regimens, medication transitions, patient activity, smoking cessation, flu vaccinations, discharge information, post-hospital follow up, use of a dyspnea scale and patient education. This year’s focus was on post-hospital follow up.
The COPD educator follows COPD patients for several weeks after hospitalization, depending on the patient’s needs and health status. If a patient is stable, they are contacted after one week and then again in a month after hospital discharge. There are more fragile patients who are contacted weekly until they are stable. There are also some who receive a home visit by the COPD educator, depending on the patient and the severity of the COPD. The outreach and management post discharge are unique and individualized.
The COPD educator has been working with insurance companies and home care companies to provide patients with special equipment and treatments at home. She continues to follow up with patients to make sure lung/respiratory tests are completed so they can qualify for pulmonary rehabilitation services.
The COPD educator also facilitates the very popular COPD community support group, the “Better Breathers Club” that meets monthly. The program is promoted through social media, local papers, radio and the COPD educator reaches out to COPD patients recently discharged from the hospital. Once the core group was established, it also spread further by word of mouth.
The multidisciplinary approach of the pathway and the post-hospital focus has proven to reduce COPD readmissions at Flambeau Hospital, providing best practice care to all COPD patients both in and out of the hospital. The team’s next focus will be to look at incorporating pneumonia into the pathway by adapting it to a respiratory pathway to broaden the scope of the COPD pathway. The COPD educator will also begin to follow pneumonia patients post hospitalization as well.
Poster: Creating a Quality Care Pathway for COPD Which Reduces Readmission Rates
Reaction from Local State Legislators:
“Flambeau’s ingenuity and innovation to provide special care for their rural community is not just an example for rural health care, it’s an example for the rest of the state. I am proud that we have thought and practice health care leaders like Kim Bortz and her team in my district.” – State Assembly Representative Beth Meyers (D-Bayfield)
“Flambeau Hospital’s achievement in reducing hospital readmissions positively impacts the health care system as a whole. Wisconsin’s top-ranking health care is a result of to the collaborative effort of a dedicated team of professionals, and a regulatory environment that allows and encourages innovation. Congrats to Flambeau for being a featured quality project by the Wisconsin Hospital Association!” – State Senate Minority Leader Janet Bewley (D-Mason)