Background Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work out improvement strategies. Method All COPD patients aged 40 or above who had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC) under the Hospital Authority of Hong Kong (HAHK) were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 1st April 2016 to 31st March 2017, with deficiencies of care identified. It was followed by a one-year implementation phase through which a series of improvement strategies were executed. Outcome of the enhancement was reviewed during Phase 2 from 1st April 2018 to 31st March 2019. Chi-square test and student’s t test were used to detect statistically significant changes between Phase 1 and Phase 2. Results A total of 2358 COPD cases were identified in Phase 1 where 658 of them were smokers. Of those smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 cases (39.8%) received Pneumococcal Vaccine (PCV). 698 patients (29.6%) had spirometry done before and 423 patients (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, Phase 2 data showed significant improvement in nearly all criteria. There was a marked increase in the SIV and PCV uptake rate, spirometry performance rate and most importantly, a significant reduction in AECOPD rate leading to hospital admission (13.5%, P = 0.000043). However, the referral rate and attendance rate of SCCS among smokers remained stagnant (P > 0.05). Conclusion Via a systematic team approach, COPD care at primary care clinics of KCC under HAHK had been significantly improved for most of the audit criteria, which in turn reduced the burden of the healthcare system.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work out improvement strategies. Method: All COPD patients aged 40 or above who had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC) under the Hospital Authority of Hong Kong (HAHK) were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 1st April 2016 to 31st March 2017, with deficiencies of care identified. It was followed by a one-year implementation phase through which a series of improvement strategies were executed. Outcome of the enhancement was reviewed during Phase 2 from 1st April 2018 to 31st March 2019. Chi-square test and student’s t test were used to detect statistically significant changes between Phase 1 and Phase 2. Results: A total of 2,358 COPD cases were identified in Phase 1 where 658 of them were smokers. Of those smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 cases (39.8%) received Pneumococcal Vaccine (PCV). 698 patients (29.6%) had spirometry done before and 423 patients (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, Phase 2 data showed significant improvement in nearly all criteria. There was a marked increase in the SIV and PCV uptake rate, spirometry performance rate and most importantly, a significant reduction in AECOPD rate leading to hospital admission (13.5%, P=0.000043). However, the referral rate and attendance rate of SCCS among smokers remained stagnant (P>0.05). Conclusion: Via a systematic team approach, COPD care at primary care clinics of KCC under HAHK had been significantly improved for most of the audit criteria, which in turn reduced the burden of the healthcare system.

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Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in the primary care. This study aimed to audit COPD care at primary care clinics of Hong Kong and to work out improvement strategies. Method: All COPD patients aged 40 or above and had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC), the Hospital Authority of Hong Kong, were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 01/04/2016 to 31/03/2017, with deficiencies identified, followed by one-year implementation phase with improvement strategies being executed. Phase 2 was from 01/04/2018 to 31/03/2019 with outcome of enhancement reviewed. Chi-square test and student’s t test were used to compare the significance of relevant changes noted. Results: 2,358 COPD cases were identified in phase 1. Among the 658 smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation and Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 (39.8%) received Pneumococcal Vaccine (PCV). 698 (29.6%) patients had spirometry done before and 423 cases (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, phase 2 data showed significance improvement in almost all criteria. There was a marked improvement in SIV and PCV coverage, spirometry performance rate and most important of all, a reduction in the AECOPD (n=294, 13.5%, P=0.000043). However, the SCCS referral rate and attendance rate among smokers remained stagnant (both P>0.05). Conclusion: COPD care at primary care clinics of KCC has been tremendously improved in most of the audit criteria via a systematic team approach, therefore reducing the burden to specialist and hospital.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive lung disease commonly encountered in the primary care. This study aimed to audit COPD care at 13 public primary care clinics of Hong Kong and to work out improvement strategies. Method: All COPD patients who were aged 40 or above and had been followed up at 13 public primary care clinics of Kowloon Central Cluster (KCC), Hong Kong were included in this clinic audit. Evidence-based audit criteria and performance standards were established after thorough literature review. Phase 1 was from 01/04/2016 to 31/032017, with deficiencies identified, followed by one-year implementation phase with improvement strategies being executed. Phase 2 was from 01/04/2018 to 31/03/2019 with outcome of enhancement reviewed. Chi-square test and student’s t test were used to compare the significance of relevant changes noted. Results: 2,358 COPD cases were identified in phase 1. Among the 658 smokers, 332 (50.5%) had been referred to Smoking Counselling and Cessation and Service (SCCS) and 289 (43.9%) actually attended it. 991 cases (42%) received Seasonal Influenza Vaccine (SIV) and 938 (39.8%) received Pneumococcal Vaccine (PCV). 698 (29.6%) patients had spirometry done before and 423 cases (17.9%) had been admitted to hospital due to acute exacerbation of COPD (AECOPD). With the concerted effort taken during the implementation phase, phase 2 data showed significance improvement in almost all criteria. There was a marked improvement in SIV and PCV coverage, spirometry performance rate and most important of all, a reduction in the AECOPD (n=294, 13.5%, P=0.000043). However, the SCCS referral rate and attendance rate among smokers remained stagnant (both P>0.05). Conclusion: COPD care at primary care clinics of KCC has been tremendously improved in most of the audit criteria via a systematic team approach, therefore reducing the burden to specialist and hospital.