Reducing 30-Day All-Cause Acute Exacerbation of Chronic Obstructive Pulmonary Disease Readmission Rate With a Multidisciplinary Quality Improvement Project.

Jonathan Rohde,Syed Anjum Khan,Thoyaja Koritala,Rahul Kashyap,Salim Surani,Binta Tambedou,Nitesh K Jain,Abraham Joseph

doi:10.7759/cureus.19917

Abstract

Our objective was to implement a comprehensive quality improvement project to decrease the 30-day readmission rate for all-cause acute exacerbation of chronic obstructive pulmonary disease (AECOPD) at a rural Midwestern community hospital in the United States. Prospective data were collected from January 1 to December 31, 2017. A total of 77 patients met the study criteria and were included for analysis. Baseline data analysis involved data for 72 patients from September 1, 2015, to October 1, 2016, and showed a 30.6% all-cause 30-day AECOPD readmission rate. The Define, Measure, Analyze, Improve, and Control (DMAIC) model was used for this quality improvement project. All aspects of this project were successfully implemented, and the resulting 30-day all-cause AECOPD readmission rate decreased to 16.9% during the study time frame. Through this comprehensive quality improvement project, the 30-day all-cause AECOPD readmission rate was reduced by 23.7%.

Highlights

Chronic obstructive pulmonary disease (COPD) affects more than 11 million Americans and is the third leading cause of death in the United States (US) [1]
All aspects of this project were successfully implemented, and the resulting 30-day all-cause acute exacerbation of chronic obstructive pulmonary disease (AECOPD) readmission rate decreased to 16.9% during the study time frame
We subsequently identified several areas for improvement and designed the implementation plan with four initiatives: COPD treatment checklist, action plan, standardized education, and follow-up telephone call within 72 hours after discharge

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) affects more than 11 million Americans and is the third leading cause of death in the United States (US) [1]. In response to a high percentage of patients returning to the hospital within 30 days after discharge, which results in increased financial costs to the health care system, the Centers for Medicare & Medicaid Services (CMS) developed the Hospital Readmissions Reduction Program [3,4]. This program uses 30-day readmissions as a benchmark for evaluation of the care provided by organizations, and CMS financially penalizes organizations for excess 30-day readmissions. The national 30-day all-cause readmission rate for AECOPD is approximately 20% [6]

Objectives

Methods

Results

Discussion

Conclusion