The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Terry R. Kisner, Frank Briggs, Michael Sweet; Center for Quality Outcomes, wvuh, Morgantown, WV

Background Chronic obstructive pulmonary disease (COPD) patients are high consumers of healthcare resources and frequently readmitted. A possible strategy to mitigate readmissions is the use of pulmonary rehabilitation. The Global initiative for Chronic Obstructive Lung Disease (GOLD) consensus report updated in 2011 supports the use of pulmonary rehabilitation in a subset of patients with a classification of moderate to very severe disease know as GOLD 2 and higher. We sought to determine our compliance with GOLD recommendation for pulmonary rehabilitation in appropriate COPD patients following discharge. Methods Patients with primary diagnosis of COPD (ICD-9 CM 491.21) were identified using an administrative data set based on billing information (universal billing form). Patients were included if they were admitted between June-Dec 2011. Patients were excluded if they were discharged to nursing home/rehab, hospice, jail, left against medical advice or expired during admission. Patients were reviewed for presence of pulmonary consult, PFT within previous year and GOLD scoring was calculated on all patients. Patients were reviewed following discharge to determine presence of pulmonary rehabilitation order and completion of any pulmonary rehabilitation visits. Results 128 patients were identified as having primary diagnosis of COPD during the study period. 22 patients were excluded (12) were discharged to hospice or expired (7) discharged to nursing home, (2) discharged to jail, (1) left against medical advice. Of the remaining 106 patients only 2 received a pulmonary consult and one patient complied with rehabilitation recommendations. 70 patients did not have documented PFT within 1 year of admission. Of the 36 patients with PFT documented GOLD calculations were completed. 32 (88.9%) qualified for pulmonary rehabilitation. No patients received an order or completed rehabilitation. Conclusion Compliance with recommending pulmonary rehabilitation based on the GOLD scoring is poor. Lack of documented PFT within 1 year was high (66%). Respiratory Therapists have an opportunity to improve documentation of PFT which would allow for ability to calculate GOLD score. Based upon our findings, patients are not receiving evidenced–based practice for pulmonary rehabilitation following discharge. Sponsored Research - None