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Chest clinic
Research update
Designing and implementing a COPD discharge care bundle
  1. Nicholas S Hopkinson1,2,
  2. Catherine Englebretsen1,
  3. Nicholas Cooley1,
  4. Kevin Kennie3,
  5. Mun Lim1,2,
  6. Thomas Woodcock1,
  7. Anthony A Laverty4,
  8. Sandra Wilson1,
  9. Sarah L Elkin1,5,
  10. Cielito Caneja1,
  11. Christine Falzon1,3,
  12. Helen Burgess1,
  13. Derek Bell1,
  14. Dilys Lai1
  1. 1NIHR Collaboration for Leadership in Applied Health Research and Care for North West London, Chelsea and Westminster NHS Foundation Trust, London, UK
  2. 2NIHR Respiratory Biomedical Research Unit of Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK
  3. 3Central London Community Healthcare, St Charles' Hospital, London, UK
  4. 4Department of Primary Care and Public Health, Imperial College London, London, UK
  5. 5Imperial Healthcare NHS Trust, St Mary's Hospital, London, UK
  1. Correspondence to Dr Nicholas S Hopkinson, NIHR Respiratory Biomedical Research Unit of Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London SW3 6NP, UK; n.hopkinson{at}ic.ac.uk

Abstract

National surveys have revealed significant differences in patient outcomes following admission to hospital with acute exacerbation of COPD which are likely to be due to variations in care. We developed a care bundle, comprising a short list of evidence-based practices to be implemented prior to discharge for all patients admitted with this condition, based on a review of national guidelines and other relevant literature, expert opinion and patient consultation. Implementation was then piloted using action research methodologies with patient input. Actively involving staff was vital to ensure that the changes introduced were understood and the process followed. Implementation of a care bundle has the potential to produce a dramatic improvement in compliance with optimum health care practice.

  • Acute exacerbation
  • quality improvement
  • pulmonary rehabilitation
  • smoking cessation
  • COPD pathology
  • lung physiology
  • lung volume reduction surgery
  • respiratory measurement
  • respiratory muscles
  • asthma epidemiology
  • asthma in primary care
  • COPD epidemiology
  • COPD exacerbations
  • emphysema
  • pulmonary rehabilitation
  • non-invasive ventilation
  • pulmonary embolism
  • COPD mechanisms
  • asthma
  • asthma mechanisms
  • cough/mechanisms/pharmacology
  • empyema
  • mesothelioma
  • pleural disease

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/thoraxjnl-2011-200233

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    Footnotes

    • Funding The work was funded by the NIHR through the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Northwest London and the NIHR Respiratory Biomedical Research Unit of Royal Brompton and Harefield NHS Trust and Imperial College.

    • Competing interests None.

    • Ethics approval The study was discussed by both the Brent Ethics Committee and the NHS Brent R&D Committee who determined that formal ethical approval was not necessary.

    • Provenance and peer review Not commissioned; externally peer reviewed.