1. Shared System of Care (COPD) It’ll take your breath away VIHA - Provincial Report Out

2. 2 Trends in Age-standardized Death Rates (Percent change between 1970 and 2002)

3. 3  Recruited 15 GPs & 6 MOAs in Comox Valley to attend a prototype for Shared System of Care (COPD)  Prototyped a model of two 3.5 hr. educational learning sessions and one action period  Action period work is designed to facilitate learning, testing tools and integrating changes into practice What we did?

4. 4 AGENDA 12:00pmRegistration and Lunch 12:30Welcome & Opening: Setting the Context – Why are we doing this? Prevalence/Reviewing data Patho physiology of the disease 1:15Screening:  COPD-6 Demo & Video o Table breakout: Practice with using COPD-6 1:45BREAK (Note: MOAs breakout until 2:40) 1:55Diagnosis  ABCs of PFT 2:40BREAK (Note: MOAs return) 2:50Respirology Department  Services Available  Referral to PFT Lab  Referral to Specialists 3:10Smoking Cessation: Strategies & Tools/Video to support 3:40Action Period Measures 3:50Evaluations and Close

5. 5 To create a system of care that improves the quality of care and experience for patients at risk for and living with COPD AIM

6. 6  Earlier identification of patients with COPD  Supporting patients to quit smoking  Enhancing patient self-management skills to manage their condition  Referring patients to appropriate community services and resources  Improving the patient experience with the system of care How will we achieve this aim?

7. 7 1.Development of a COPD registry 2.10 screenings using COPD 6 3.10 smoking cessation interventions 4.3-5 COPD exacerbation plans 5.Review, use if possible new referral form and provide feedback at Learning Session #2 Note: For #2-4 can be different patients Action Period Measurement

8. 8 AP1 - COPD Data Collection Sheet  Please fill this form out and return via fax to Kate

9. 9 Stepped Approach to Care

10. 10  The Vitalograph COPD-6 USB used for initial screening.  Benefits include: › Reliable test › Ease of use › Data download capability Screening – COPD-6 USB

11. 11 COPD-6 Movie

12. 12 St. Joseph’s General Hospital Respiratory Department Craig Dickson, RRT

13. 13 ABCs of PFT  Normal FVC=100% FEV1=80% FEV6=90% FEV1/FEV6=85%  Moderate COPD FVC=80% FEV1=70% FEV6=80% FEV1/FEV6=65%  Severe COPD FVC=65% FEV1=50% FEV1/FEV6=60%

14. 14 St.Joseph’s PFT Referral process Testing options for COPD Contraindications Wait times Interpretations ABCs of PFT

15. 15 GP- Respirology Referral Form The cohort will trial this form over the Action Period.

16. 16 Smoking Cessation Derek Poteryko, M.D.

17. 17 1.How to approach and discuss smoking cessation with a smoker at the various stages of change 2.Understand the efficacy of the most common cessation strategies 3.Be aware of the various community resources for smoking cessation 4.Be able to offer a timely and effective smoking intervention Session Objectives

18. 18 Evaluations

19. 19

20. 20 Questions?