1. Implementing a COPD care bundle- the Southend experience Dr Duncan Powrie Consultant Chest Physician March 2015

2. 2010 discharge checklist first developed Completion rates were poor Lack of responsibility for actions No clear division between nursing and medical responsibility for tasks Discharge checklist meant often left until day of discharge Only implemented on respiratory wards

3. Attempted improvements Care bundle Nominated professionals for each action Column on whiteboard However when audited completion rate was only 30%

4. Aims 100% completion rate All wards – respiratory and GIM Involvement of community teams

5. COPD CQUINN Joint project with community services Bundle agreed Project manager appointed (band 6) assisted by COPD nurse Completion recorded on systmOne Community staff informed and all patients followed up and bundle completed

12. 15 referred to LTC

13. 100% of patients are given leaflets and education regarding COPD. 100% of patients are given advice on flu and pneumonia vaccines. 45% of patients where referred for assisted discharge (RRT). 65% of patients where referred to LTC (Although this includes all first admissions which is typically 35-40% of our overall admissions) Other bundle elements

14. What have we learnt? Implementing the bundle is easier said that done Ongoing education, commitment and badgering is insufficient Dedicated individual with responsibility is required