Title is 36-40pt. Arial
By Laura Kranitz RRT CPFTRespiratory Care Practitioners As A
Health Care Resource A Vision for the Future Careof Our COPD
Patients.An Investigation of the Opportunity for Utilizing
Respiratory Therapists in the Hospital and Clinic Settings to Aid
the Discharge Process of Our COPD Patients Leading to Improved Post
Care Management, Decreased Hospital Admissions and Reduced Health
Care Costs
Aurora Health Care, Inc.
Aurora Health Care, Inc.General BackgroundAccording to the COPD
FoundationChronic Obstructive Pulmonary Disease (COPD)Is an
umbrella term used to describe progressive lung diseases including
emphysema, chronic bronchitis, refractory (non-reversible) asthma
and some forms of bronchiectiasisIn 2015 CMS to reduce IPPS
reimbursements to hospitals with excessive COPD readmissions
Aurora Health Care, Inc.COPD StatisticsAccording to the CDC:70%
of the 24M US COPD patients are under the age of 65.Of those are
undiagnosed% of WI Adult Population with COPDAge Groups:45-54 =
6.2%55-64 = 7.1%65-74 = 11.4%> 75 = 9.1%
Aurora Health Care, Inc.Data from the COPD Foundation COPD
Readmissions Summit October 11, 2013Over 800,000 hospital
admissions per year are from COPD About 20% of hospitalized
patients with COPD are readmitted within 30 days.Another 3.8 M
stays included COPD as a secondary or complicating condition.
1 in 5 hospitalized individuals over age 40 has a diagnosis of
COPD
Aurora Health Care, Inc.COPD Foundation Physician Survey61.1% of
PCPs consider their COPD education exposure inadequate64.4% of PCPs
value clinical practice guidelines to help guide clinical
practice.44.9% of PCPs are unaware of the current COPD clinical
practice guidelines.
Aurora Health Care, Inc.The Global Initiative for Chronic
Obstructive Lung Disease (GOLD)Developed in 1998 with the WHO, NIH
and National Heart, Lung and Blood Institute. Evidence based
clinical practice guidelines updated for 2014.Provides standardized
treatment and medication recommendations based on the latest
scientific studies.
Aurora Health Care, Inc.The Global Initiative for Chronic
Obstructive Lung Disease (GOLD)Classifies COPD patients into four
groups based onSymptomsDegree of airflow limitation (using
spirometry)Risk of exacerbationComorbiditiesGOLD requires a
spirometry in the presence of a post bronchodilator to provide a
clinic diagnosis of COPD.All health care workers who care for COPD
patients should have access to spirometry
Aurora Health Care, Inc.How Can Respiratory Therapists Help
Reduce Hospital Readmissions?They are uniquely trained to assist
physicians in both the inpatient and outpatient settings.In the
hospital RTs can: Assess patients per protocol to GOLD
classifications including spirometry.Become valuable members of a
multidisciplinary discharge planning team as soon as patient is
admitted. (MD,RN,RT, SW, CM, PT/OT)Educating patients and
caregivers on the disease, use of medications and various DME
devices prior to discharge.
Aurora Health Care, Inc.How Can Respiratory Therapists Help
Reduce Hospital Readmissions?In the clinic RTs can:Assist PCPs by
classifying the severity of patients COPD per GOLD using
spirometry.Perform hospital follow up visits that include:Patient
and caregiver education on the disease process and use of various
inhalers and medications.Develop with the patient their personal
COPD Action planHow to avoid risks by reviewing smoking cessation
and vaccinations and oxygen therapyReferrals for out patient
pulmonary rehab.Document, monitor and improve outcomesDevelop a
care team between the PCP,RN, patient, family and RT.
Aurora Health Care, Inc.Use Trained, Experienced Respiratory
Care Practioners (RCP) Clinical SpecialistsNBRC Registered
Respiratory Therapist (RRT)AARC COPD Certified EducatorNAECB Asthma
Educator (AE-C)Health Science Related Bachelor DegreeHR 2619
Medicare Respiratory Therapist Access Act of 2013It will amend
Medicare Part B to provide coverage of pulmonary self-management
education and training by a qualified RCP in the physician practice
setting.
Aurora Health Care, Inc.UC Davis Health System Using RCPs as
COPD Case Managers Results of Two Year StudyReceived a grant from
the University of California
Aurora Health Care, Inc.How Can Hospitals Reduce
Readmissions?American Hospital Association (AHA)
RecommendationsFocus on avoidable hospitalizationsEnhance discharge
planningPartner with post-acute care providersAurora Medical Center
GraftonAurora Advanced HealthcareUse health care personnel with
advanced training to provide disease specific patient
education.Develop a high-risk patient readmission tool using the
evidence based GOLD 2014 guidelines.Appoint a discharge advocate to
schedule PCP follow up visits and follow up telephone calls.Develop
personalized COPD Action plans, teach self-management and make
referrals to pulmonary rehab.
Aurora Health Care, Inc.ReferencesGlobal Initiative for Chronic
Obstructive Lung Disease, 2013 (WHO, NIH and National Heart, Lung
and Blood Instittute)COPD Management, Avoiding Readmissions Due to
Acute Exacerbations, RT Magazine, October 2013 (part 1), November,
2013 (part 2) by Timothy Opt Holt, EDD, RRT, AE-C FAARCReducing
COPD Readmissions, Webinar 4/28/2014 RT MagazineDeb McGowan COPD
Foundation (Carolinas Healthcare System (CHS)Samual Loue
Aurora Health Care, Inc.
