COPD exacerbation care bundle improves standard of care, length of stay, and readmission rates

• Published in: International journal of chronic obstructive pulmonary disease 2016-01, Vol.11 (1), p.577-583
• Main Authors: Parikh, Raj, Shah, Trushil G, Tandon, Rajive
• Format: Article
• Language: English
• Subjects: acute exacerbation chronic obstructive lung disease; Analysis; Antibiotics; Automation; care bundle; Case-Control Studies; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; COPD; Disease Progression; Evidence-based medicine; Female; Global health; Health care costs; Health care policy; Hospital costs; Humans; Inhalers; Intensive care; Length of stay; Length of Stay - statistics & numerical data; Male; Medical records; Medical referrals; Middle Aged; Mortality; Original Research; Patient Care Bundles; Patient education; Patient Readmission - statistics & numerical data; Pneumonia; Prospective Studies; Pulmonary Disease, Chronic Obstructive - therapy; Standard of care; Standard of Care - standards; Steroids
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S100401

COPD is the third leading cause of death in the world. Utilizing care bundles during acute COPD exacerbations results in fewer complications and lower costs. Our aim was to construct a COPD exacerbation care bundle and evaluate the effects on patient care. We conducted a prospective analysis of 44 patients admitted with a COPD exacerbation to a single tertiary care facility. Primary outcomes included length of stay, readmission rates, and hospital costs. Secondary outcomes included patient education, pulmonologist follow-up, and timeliness of medication administration. Two cohorts were analyzed: those treated with an electronic COPD care bundle (cases; N=22) versus those treated without the care bundle (controls; N=22). Mean length of stay (51.2 vs 101.1 hours in controls; P-value =0.001), 30-day readmission rates (9.1% vs 54.4% in controls; P-value =0.001), and 60-day readmission rates (22.7% vs 77% in controls; P-value =0.0003) decreased in the care bundle group. Ninety-day hospital costs had a significant difference in the care bundle group (US$7,652 vs US$19,954 in controls; P-value =0.044). Secondary outcomes included a 100% rate of COPD inhaler teaching (vs 27.3% in controls; P-value