COPD Discharge Bundle Project Jo Congleton Clinical Lead KSS AHSN COPD Discharge Bundle Project Jo Congleton Clinical Lead

KSS Respiratory Programme Oxygen Clinical Network: 81 Email and Breathing Matters Distribution list: 895 PR Clinical Network: 108 Virtual NHS Network: 397 Twitter followers: 569 11 acute trusts 16 acute sites Respiratory Expert Advisory Group: 24 So we believe we can work well to help deliver the AHSN objectives of reducing variation, reducing unscheduled care, increasing research capacity, and wealth creation KSS Respiratory Programme

30day re-admission rate stable since 2012-13 at 23%

COPD Discharge Bundle Project Collaborative event to explore enthusiasm for COPD discharge bundle 23/1/2014 Evidence presented Proposal to introduce EQ COPD discharge bundle in Kent, Surrey & Sussex - accepted Wording of Bundle, data dictionary agreed Reporting tool developed Data collection commenced October 2014

COPD Discharge Bundle Elements   Referral to smoking cessation service if a current smoker An assessment of suitability for and enrolment into a pulmonary rehabilitation programme Provision of written information and rescue packs for future exacerbations Ensure that patient can demonstrate good inhaler technique whilst on the wards Ensure that they have appropriate follow up once discharged from hospital

% of HES coded COPD admissions with bundle data reported

ACS = % with all elements delivered CQS = % of total elements delivered

Summary Data: % of reported patients who receive: Oct 2014 Oct2015 Inhaler technique 24% 49%* Written information/action plan 9% 40% Rescue Pack 27% Smoking cessation 59% 72%* Refer PR 47% Follow up 47%* All elements 4% 25% * Significant change at P=0.05 level

Readmission trend before and after bundle

Problems 3/11 trusts not reporting Rescue medication Coding, coding, coding

Conclusion It is possible to implement a more unified approach to delivery across a large geographical area We plan to continue to assess impact on outcome measures