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New COPD Initiatives in Canterbury “It's not about the physiology”

New COPD Initiatives in Canterbury “It's not about the physiology”. Carol Limber Alliance Manager for Acute Demand. During 2011 COPD in Christchurch accounted for:. 1,256 admissions (3.5 per day) 5,952 bed days (two wards in winter) 1 in 4 being readmitted within 28 days

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New COPD Initiatives in Canterbury “It's not about the physiology”

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  1. New COPD Initiatives in Canterbury “It's not about the physiology” Carol Limber Alliance Manager for Acute Demand

  2. During 2011 COPD in Christchurch accounted for: 1,256 admissions (3.5 per day) 5,952 bed days (two wards in winter) 1 in 4 being readmitted within 28 days 4 out of 5 arriving by ambulance

  3. Diabetes hospital admission ratesOECD

  4. COPD hospital admission ratesOECD

  5. Admissions to ChCh hospital for COPD – milder disease increasing

  6. ED attendance mode for admitted COPD patients

  7. COPD admission day of week Count

  8. ED attendance with Resp. disease(>85% admitted) 09:00 – 17:00

  9. The Tsunami of COPD All these people in hospital are there because there are more people out there, all getting worse We need more beds to cope People come to hospital with COPD after hours

  10. What were we trying to change? • Patient response – how to stay well • Ambulance responses - assess severity by agreed criteria, knowing patient prior status • Call practice if well • Involve Acute Demand / 24 hour surgery if less well • Severe exacerbations or uncertain – ED • ED and AMAU responses – consider early supported discharge – ADMS or CREST • Acute Demand nurses in ED and AMAU • Enhance Acute Demand skill to treat COPD • Visibility of patient history / plan through technology CCMS & eSCRV

  11. Early Results & KPIs

  12. Outcomes • Count of Acute Admissions • ED Attendances (Total and those brought by Ambulance) • Occupied bed days • % of patients admitted

  13. COPD admissions last 105 weeks

  14. Bed days last 105 weeks

  15. Bed days E65B last 105 weeks

  16. E65B Admissions last 105 weeks

  17. COPD Ambulance Numbers(1st July 2012 – 1 March 2013)

  18. Eye Openers……. • System Response • The numbers! • Ambulance • Primary Care GP response Lessons Learned…… • Education / communication / engagement • Keeping it simple • What does success look like?

  19. Winter of 2013... • More of the Same • Meetings with Ambulance ramping up • Risk stratification / use of Med’s database • Joined up response - CREST – hospital and community • Additional links with the MDT

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