Chronic obstructive pulmonary disease (COPD) is a chronic condition that leads to signi cant morbidity and mortality. Management of COPD hospitalizations utilizing an evidence-based care bundle can provide consistent quality of care and may reduce readmissions. MethodsThis single center retrospective cohort study evaluated readmission rates in patients hospitalized with a COPD exacerbation. Patients in the pre-intervention cohort received usual care while post-intervention cohort received an innovative inpatient COPD care bundle. The bundle focused on optimizing care in ve areas: consults, inpatient interventions, education, transitions of care, and after discharge care. To ensure consistency of interventions, a formal checklist of items was maintained. ResultsIn this study, 149 subjects were included in the pre-intervention cohort and 214 subjects were included in the post-intervention cohort. Thirty-day readmission rates were lower in the post-intervention cohort, 22.4% vs. 38.3% (p=0.001). A reduction in 60-day and 90-day readmission rates was also observed, 13.7% vs. 40.3% (p< 0.001) and 10.1% vs. 32.2% (p<0.001), respectively.

Purpose Chronic obstructive pulmonary disease (COPD) is a chronic condition that leads to significant morbidity and mortality. Management of COPD hospitalizations utilizing an evidence-based care bundle can provide consistent quality of care and may reduce readmissions. Methods This single center retrospective cohort study evaluated readmission rates in patients hospitalized with a COPD exacerbation. Patients in the pre-intervention cohort received usual care while post-intervention cohort received an innovative inpatient COPD care bundle. The bundle focused on optimizing care in five areas: consults, inpatient interventions, education, transitions of care, and after discharge care. To ensure consistency of interventions, a formal checklist of items was maintained. Results In this study, 149 subjects were included in the pre-intervention cohort and 214 subjects were included in the post-intervention cohort. Thirty-day readmission rates were lower in the post-intervention cohort, 22.4% vs. 38.3% (p=0.001). A reduction in 60-day and 90-day readmission rates was also observed, 13.7% vs. 40.3% (p< 0.001) and 10.1% vs. 32.2% (p<0.001), respectively. Conclusion Bundled care is an effective and inexpensive method for institutions to provide consistent and quality care. The findings of this study demonstrate that the implementation of a COPD care bundle is an effective strategy to decrease hospital readmissions.

This is a retrospective cohort study comparing patients who received chronic obstructive pulmonary disease (COPD) standard of care (SOC) in the preintervention cohort versus the postintervention cohort who received a case manager-led COPD care bundle at a postacute care (PAC) facility. The patient sample includes patients between the ages of 65 and 85 years, who were diagnosed with an exacerbation of chronic obstructive pulmonary disease (ECOPD), hospitalized at a single-site community hospital between 2016 and 2019, and required transfer to a PAC facility at the time of discharge. The preintervention cohort involved 193 patients who received the SOC and 445 patients received tailored care with a COPD care bundle.

Purpose of the Study: To evaluate the relationship between a case manager-led pneumonia care bundle at skilled nursing facilities (SNFs) and 30-day hospital readmissions for pneumonia. Primary Practice Settings: The primary practice settings included patients hospitalized with pneumonia at 2 community hospitals between October 2018 and June 2019 and who were subsequently transferred to an SNF. Methodology and Sample: A retrospective cohort study was completed comparing patients in the preintervention cohort who received pneumonia standard of care versus patients in the postintervention cohort who received a case manager-led evidence-based pneumonia care bundle at an SNF. From October 2018 to June 2019, patients admitted with pneumonia to 2 community hospitals in Northwest New Jersey were enrolled in the preintervention cohort. Patients admitted with pneumonia from January 2020 to June 2021 were enrolled in the postintervention group. The primary outcome was to reduce 30-day readmission rates for all patients discharged from the hospital to an SNF with pneumonia. Results: Ninety-nine patients were enrolled in the preintervention cohort and 34 patients were enrolled in the postinterventions cohort. Thirty-day readmission rates were lower in the postintervention cohort (24.2% vs. 17.7%). This reduction in readmission rates was clinically significant, demonstrating a 27% reduction for all patients discharged from the hospital to an SNF with pneumonia. Implications for Case Management Practice: Individualized pneumonia self-management education can be easily implemented in SNFs to improve quality-of-care outcomes for patients. Our health care system collaborates with several SNFs to decrease 30-day hospital readmission. The pneumonia care bundle includes specific measures to improve the transition of care for patients with pneumonia by decreasing the variability of patient care after discharge from the hospital to an SNF. It was hypothesized that to decrease readmissions from the SNFs, we needed to address the quality of care provided by the SNFs by using a 2-prong approach; education of SNF staff on the pneumonia care bundle, and in-person weekly follow-up visits in the SNF until discharge from the SNF to the patient's home.

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