The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

OUTCOMES IN SEVERE COPD PATIENTS USING A 10-DAY PULMONARY REHABILITATION PROGRAM CRITICAL PATH.

J. Bowen B.S., C.R.T.T., C. Wollschlager M.D., P. Scalise M.D., D. Gerardi M.N., J. Votto D.O. Hospital for Special Care, New Britain, CT, University of CT School of Medicine, Farmington, CT, U.S.A.

With managed care and capitation now dictating reimbursement, the ability to be able to provide efficient, effective and quality patient care has become crucial. Since May of 1995, the use of a 10-day critical path in our comprehensive, multi- disciplinary inpatient pulmonary rehabilitation program (PRP) has allowed us to achieve this goal. (Random chart audits of fifteen prior PRP patients resulted in a compilation of supportive data to base our 10-day critical path on.) Patients admitted to our PRP have advanced COPD (FEVI, less than 50%; FVE, less than 2.5 liters). During its first year in use, forty-five (45) patients have successfully completed the PRP using the critical path. We have been able to document both objective and subjective benefits. The path has been utilized as a benchmark for rapid evaluation of patient progress. It has resulted in the delivery of quality patient care and has facilitated a true team approach by the professionals who deliver the care. Continuous outcome monitoring (i.e., variance data) is simplified by the critical path worksheet and allows us to adjust the path as necessary.

Before Path After Path

Apr. 1994- Apr. 1995- Aug. 1995- Nov. 1995-

Mar. 1995 July 1995 Oct. 1995 Jan. 1996

- # of Pats. 46 13 7 7

- LOS 10 days 7 days 6 days 8 days

- Hospital

Charges $12,765 $8,690 $6,633 $9,838

- 12 Min.

Walk:

\delta p PRP 68% 74% 75% 76%

- % D/C to

Home 96% 85% 86% 100%

Reference: OF-96-176

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