COPD patients breathing easier from the comfort of their homes
Left to right: Su Lyn Leong, ambulatory nurse Gail, ACTaLN Nurse Deborah Jones and physiotherapist Jennifer Gresham
Rockingham General Hospital (RGH) patients with Chronic Obstructive Pulmonary Disease (COPD) are benefiting from a new multi-disciplinary service which aims to provide an improved foundation of care and reduce readmission rates.
COPD is a debilitating disease which causes the pipes of the lungs to narrow, resulting in symptoms including severe breathing difficulties, coughing and increased phlegm. One of the most common causes of COPD is smoking.
A year ago, the COPD readmission rate for RGH was 24.7 percent, which meant that for every four patients who were admitted to hospital, one was coming back within 28 days.
With the aim to reduce the COPD readmission rates at RGH, the COPD Rapid Access Clinic was implemented by Respiratory Consultant Su Lyn Leong in March 2021 and has since seen a reduction in COPD readmission rates to 15 percent. This data was recently presented at a Health Round Table meeting and was awarded a Certificate of Achievement, with the team being recognised for their innovation to make and lead change, that has resulted in improved patient care.
The COPD Rapid Access Clinic is an outpatient service for discharged patients. Patients are initially supported in the community immediately post discharge by the Aged Care and Transition Liaison Nurse (ACTaLN) team, and subsequently seen in a joint review with a doctor and a physiotherapist within four weeks of discharge. Patients are given a firm diagnosis, a COPD action plan if appropriate, smoking cessation information, a lung disease exercise program which reduces breathlessness, education on techniques to phlegm management, and an understanding of the basics of COPD management, including the right inhaler and how to use it correctly.
COPD Rapid Access Clinic Lead Su Lyn Leong said the success of the service was by no means a one department achievement.
“The implementation of this new service model relied on likeminded healthcare staff, who wanted to make a difference,” Su Lyn said.
Involved in the service are doctors from the Aged Care Rehabilitation Unit and general medicine wards who refer patients to the clinic, outpatients and ambulatory care who have given the clinic access to rooms to see patients, physiotherapists, respiratory physicians and the ACTaLN team.
“Initially our focus was on making a difference to our patients by providing a one stop shop so that they are given the best chance of being able to manage their COPD at home,” Su Lyn said.
“We weren’t expecting huge improvements in the readmission rate, we hoped we would of course see this, but this result has exceeded our expectations – I am really proud of the whole team.”
Previously, when COPD patients were discharged and experienced a flare up, they often were not sick enough to be hospitalised, but also not well enough to be on their own at home. The ACTaLN team filled this gap by upskilling in inhaler technique and general respiratory education to be able to see these patients at home, provide reassurance and support, and check they were using their inhaler correctly.
More recently, Silver Chain and Asthma WA have come on board to offer post clinic support to patients with ongoing education including inhaler technique checks.
As the clinic continues to grow, the aim is to maintain the COPD readmission rate at 15 percent and work towards starting the COPD action plan process earlier, on the ward when the patient is in hospital before they are discharged.
