CHEST COPD Immersion Program June 6-7, 2023-Optimizing COPD Acute Care Patient Outcomes Using a Standardized Transition Bundle and Care Coordinator Article

Optimizing COPD Acute Care Patient Outcomes Using a Standardized Transition Bundle and Care Coordinator Article

Pdf Summary

This randomized clinical trial aimed to evaluate the effectiveness of a COPD transition bundle, with and without a care coordinator, on rehospitalizations and ED revisits. The study included a total of 3,710 patients discharged from five hospitals in Alberta, Canada. The transition bundle consisted of seven elements including adequate inhaler technique, discharge summary sent to the family physician, respiratory medications optimization, written discharge management plan, referral to pulmonary rehabilitation, screening for frailty and comorbidities, and assessment for smoking cessation. The primary outcomes were 7-day, 30-day, and 90-day readmissions, median length of stay (LOS), and 30-day ED revisits. <br /><br />Results showed that patients in the transition bundle group were 83% less likely to be readmitted within 7 days and 26% less likely to be readmitted within 30 days of discharge compared to the usual care group. However, there was no significant difference in 90-day readmissions between the two groups. The transition bundle was associated with a longer median LOS and a 76% increased risk of a 30-day ED revisit. The addition of a care coordinator did not influence readmission or ED revisit rates. The transition bundle did increase the likelihood of patients visiting their primary care physician within 14 days of discharge.<br /><br />The study concludes that the COPD transition bundle was effective in reducing 7-day and 30-day hospital readmissions, likely by facilitating care continuity with primary care providers. However, it was also associated with longer hospital stays and an increased risk of ED revisits. The care coordinator did not improve outcomes in this study. Further research is needed to understand the factors influencing bundle uptake and to optimize care transitions for patients with COPD.

Keywords

randomized clinical trial

COPD transition bundle

care coordinator

rehospitalizations

ED revisits

Alberta, Canada

inhaler technique

discharge summary

respiratory medications optimization

care continuity