The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts

TRANSITION OF CARE PROGRAM AND REHOSPITALIZATION RATES FOR PATIENTS WITH COPD WHO REQUIRE HOME OXYGEN THERAPY FOLLOWING AN EXACERBATION: AN UPDATE.

Brian W. Carlin1, Kim Wiles2, Dan Easley2, Nan Rees3; 1Allegheny General Hospital, Pittsburgh, PA; 2Klingensmith HealthCare, Ford City, PA; 3St. Clair Hospital, Pittsburgh, PA Background: The overall 30

Background: The overall 30 day readmission rate for patients with COPD following hospitalization for an exacerbation approaches 25% in the Western Pennsylvania area. Strategies need to be developed to effect a reduction in this readmission rate. Objective: To evaluate the effects over the past year of a home care based, respiratory therapist centered transition of care program for patients who require home oxygen therapy following hospital discharge from an exacerbation. Method: The Discharge, Assessment and Summary at Home (D.A.S.H., Klingensmith HealthCare) program was implemented for patients who require supplemental oxygen use following hospital discharge. Data from the initial six months was reported previously. This data is a summary of the fourteen months of the program. The program consists of face-to-face visits by a respiratory therapist with the patient in the home environment on days 2, 7, and 30 following hospital discharge. Phone interviews by a care coordinator are then conducted in between these visits. Education, behavior modification, skills training, oxygen titration during performance of activities of daily living, clinical assessment, and adherence data collection are key components of the program. Four hundred thirty nine patients who were discharged from the hospital and required supplemental oxygen were enrolled into the program. Results: The 439 patients enrolled were from 23 different hospitals in the Western Pennsylvania area from March 2010 through May 2011. The primary discharge diagnosis was: COPD in 301 (69%); CHF 57 (13%); hypoxemia 33 (8%); pneumonia 19 (4%); and other 29 (7%). The 30 day readmission rate for the entire group was 7%. The 30 day readmission rate for those with COPD due to a recurrent exacerbation was 3% (8/301), for those with CHF due to an exacerbation was 5% (3/57), and for those with non-COPD diagnoses for any reason was 7% (3/81). 6% (18/301) patients with COPD were readmitted within 30 days for a diagnosis other than an exacerbation. Conclusions: Since the inception of the respiratory therapist based transition of care program, the 30 day rehospitalization rate remains below 7% for patients who were discharged from the hospital and required supplemental oxygen.
Sponsored Research - Klingensmith Health Care is a provider of DME equipment and is the developer of the program. Dan Easley and Kim Wiles are employees of Klingensmith Healthcare. Dr. Carlin and Ms. Rees have no financial ties to the program.