Clinical pathway for acute COPD exacerbations reduces hospital stay and readmission

1. Clinical pathway for acute COPD exacerbations reduces hospital stay and readmission G. Celis RN, C. Lodewijckx LN, A. Schoonis RN, M. Decramer MD, PhD Pneumology Division, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium Multidisciplinary team BACKGROUND • Medical doctor • Nurse • Physiotherapist • Dietician Social worker Psychologist Ergotherapist COPD patients have frequent hospital admissions and a longer hospital stay compared to other chronic illness. In 2000 we implemented a 10-day clinical pathway (CP) for acute COPD exacerbations. In May 2003 the duration was reduced to 8 days. The CP describes the tasks of the multidisciplinary team: medication, examinations, diet, physiotherapy, education among lifestyle modification and therapy, nursing care and discharge management. The aim of the CP is to standardise the treatment, to reduce the length of stay and to screen patients for a rehabilitation program. CONCLUSIONS Patients hospitalized for an acute COPD exacerbation and involved in a clinical pathway have a:  significantly shorter duration of hospital stay  significantly higher readmission interval during the first year after discharge. AIMS OF THE STUDY RESULTS To explore the benefit of a clinical pathway:  on the hospital stay  and the readmission interval in patients hospitalized due a COPD exacerbation. The mean hospital stay for CP patients was 10.24 days (SD ±3.940) and the control group had a mean hospital stay of 13.21 (SD ± 12.663) (p=0.034). During the first year after discharge 35.3% of the CP patients had a mean readmission interval of 160,79 days (SD ± 117.80) and 34,0% of the control group had a mean readmission interval of 94,38 days (SD ± 95.16) (p= 0.029). Fig.1: Mean hospital stay for an acute COPD exacerbation. CHALLENGE METHODS To include every COPD patient hospitalized for an acute exacerbation in the critical path. A retrospective study. 68 CP patients and 94 control patients hospitalized due an COPD exacerbation during the year 2004. Fig.2: Mean readmission interval during the first year after discharge.