Strategies to Prevent Readmissions to Hospital for COPD: A Systematic Review

Sharpe, Isobel; Bowman, Meghan; Kim, Andrew; Srivastava, Siddhartha; Jalink, Matthew; Wijeratne, Don Thiwanka

doi:10.1080/15412555.2021.1955338

Cited by 6 publications

(7 citation statements)

References 110 publications

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“…It is important to note that before the implementation of sprint teams, routine improvement efforts with SBAR Similarly, common practices such as insertion bundling and maintenance bundling order sets, while supported in the literature for preventing CAUTIs (Hanchett, 2012), were not producing the desired benefits, nor were they commonly used to reduce readmission cases (Anderson et al, 2015;Kong & Wilkinson, 2020;Ramkumar et al, 2015;Sharpe et al, 2021;Yu et al, 2015). The Scripps Health sprint teams are not given specific reduction achievement goals so that leadership can instead test new processes and try nonmathematical goal-setting.…”

Section: Discussionmentioning

confidence: 99%

“…It is important to note that before the implementation of sprint teams, routine improvement efforts with SBAR (situation, background, and root cause analysis) evaluations were frequently met with resistance from staff and providers because of the increased time requirements and detailed processes. Similarly, common practices such as insertion bundling and maintenance bundling order sets, while supported in the literature for preventing CAUTIs (Hanchett, 2012), were not producing the desired benefits, nor were they commonly used to reduce readmission cases (Anderson et al, 2015; Kong & Wilkinson, 2020; Ramkumar et al, 2015; Sharpe et al, 2021; Yu et al, 2015).…”

Section: Discussionmentioning

confidence: 99%

“…In developing the initiative described here, sprint teams reviewed OFIs daily or whenever a case opportunity was identified. Each checklist was developed from a literature review of evidence-based findings from various sources appropriate to each team’s work (Agency for Healthcare Research and Quality, 2015; Anderson et al, 2015; Berrios-Torres et al, 2017; Centers for Disease Control and Prevention, 2020; DePuccio et al, 2020; Hanchett, 2012; Kong & Wilkinson, 2020; Michikio et al, 2021; Ramkumar et al, 2015; Sharpe et al, 2021; Thirukumaran et al, 2020; Yu et al, 2015; Ziaeian & Fonarow, 2016). The teams also reviewed cases that contributed to the penalty programs in the prior year.…”

Section: Methodsmentioning

confidence: 99%

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Sprint Team Approach Yields Rapid Improvement in Leapfrog Quality Indicators

Sharieff,

Uejo

2024

Journal of Healthcare Management

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SUMMARY Goal: Patient safety and quality care are two critical areas that every healthcare organization strives to grow and improve upon. At Scripps Health, specific efforts reviewed for this article were implemented to reduce hospital-acquired conditions and hospital readmissions that are components of Centers for Medicare & Medicaid Services programs and Leapfrog Hospital Survey scores. Methods: Sprint teams, a novel approach to rapidly develop a checklist for lower-performing care improvement areas, were implemented after an internal review of existing tools and an evidence-based literature review. These areas included catheter-associated urinary tract infections (CAUTIs), central-line associated bloodstream infections (CLABSIs), Clostridioides difficile (C. diff.) and methicillin-resistant Staphylococcus aureus (MRSA) infections, chronic obstructive pulmonary disease (COPD) and heart failure readmissions, surgical site infections and handwashing, bar coding, and the computerized physician order entry components of Leapfrog scoring. The checklist for each area served as a teaching tool for staff and a guideline for case review to ensure that standard work was routinely performed. Principal Findings: The sprint teams showed dramatic results in the initial focus areas. From a baseline standardized infection ratio (SIR) of 1.141 for CLABSIs, the sprint team reduced the SIR to 0.885 in Year 1 of the program and to 0.687 in Year 2. For CAUTIs, the SIR decreased from a baseline of 1.391 in Year 1 to 0.720 in Year 2. C. diff. infections fell from 0.422 to 0.315 in Year 1 and to 0.260 in Year 2. While the MRSA SIR did not improve during the first year, the MRSA reduction sprint team showed success in Year 2 with a decrease in the SIR from 0.537 to 0.245. Readmission reduction sprint teams focused on heart failure, COPD, and total hip and knee complications. The teams also achieved positive results in reducing readmissions by following checklists and reviewing each readmission case for justification. Practical Applications: Rapid change can be safely and effectively implemented with multidisciplinary sprint teams. Developed with an evidence-based, case review approach, sprint team checklists can help to standardize processes for the review of any infections or readmissions that occur in the inpatient arena.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Sprint Team Approach Yields Rapid Improvement in Leapfrog Quality Indicators

Sharieff,

Uejo

2024

Journal of Healthcare Management

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“…Patients with chronic obstructive pulmonary disease (COPD) often need to be hospitalised due to exacerbations of their underlying disease, imposing a significant clinical and economic burden on the healthcare system [1]. Hence, it is crucial to apply evidence-based strategies for preventing these hospital readmissions.…”

Section: Management Of Exacerbations In Airway Diseasesmentioning

confidence: 99%

ERS International Congress 2022: highlights from the Respiratory Clinical Care and Physiology Assembly

et al. 2023

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It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, clinical trials and qualitative research that were presented during the 2022 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 – Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.

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“…The scarcity of studies including healthcare contacts across providers [ 16 ], or studies focusing on system level variables (e.g. care type, general practitioner (GP) visit frequency) [ 17 ] may be related to these difficulties. Hence, there is a lack of literature describing the frequency and variation in service use by types and combinations of care providers, and their association with hospital admissions and readmissions.…”

Section: Introductionmentioning

confidence: 99%

Associations between outpatient care and later hospital admissions for patients with chronic obstructive pulmonary disease - a registry study from Norway

Moger,

Holte,

Amundsen

et al. 2024

BMC Health Serv Res

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Background Although chronic obstructive pulmonary disease (COPD) admissions put a substantial burden on hospitals, most of the patients’ contacts with health services are in outpatient care. Traditionally, outpatient care has been difficult to capture in population-based samples. In this study we describe outpatient service use in COPD patients and assess associations between outpatient care (contact frequency and specific factors) and next-year COPD hospital admissions or 90-day readmissions. Methods Patients over 40 years of age residing in Oslo or Trondheim at the time of contact in the period 2009–2018 were identified from the Norwegian Patient Registry (in- and outpatient hospital contacts, rehabilitation) and the KUHR registry (contacts with GPs, contract specialists and physiotherapists). These were linked to the Regular General Practitioner registry (characteristics of the GP practice), long-term care data (home and institutional care, need for assistance), socioeconomic and–demographic data from Statistics Norway and the Cause of Death registry. Negative binomial models were applied to study associations between combinations of outpatient care, specific care factors and next-year COPD hospital admissions and 90-day readmissions. The sample consisted of 24,074 individuals. Results A large variation in the frequency and combination of outpatient service use for respiratory diagnoses (GP, emergency room, physiotherapy, contract specialist and outpatient hospital contacts) was apparent. GP and outpatient hospital contact frequency were strongly associated to an increased number of next-year hospital admissions (1.2–3.2 times higher by increasing GP frequency when no outpatient hospital contacts, 2.4-5 times higher in combination with outpatient hospital contacts). Adjusted for healthcare use, comorbidities and sociodemographics, outpatient care factors associated with lower numbers of next-year hospitalisations were fees indicating interaction between providers (7% reduction), spirometry with GP or specialist (7%), continuity of care with GP (15%), and GP follow-up (8%) or rehabilitation (18%) within 30 days vs. later following any current year hospitalisations. For 90-day readmissions results were less evident, and most variables were non-significant. Conclusion As increased use of outpatient care was strongly associated with future hospitalisations, this further stresses the need for good communication between providers when coordinating care for COPD patients. The results indicated possible benefits of care continuity within and interaction between providers.

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Strategies to Prevent Readmissions to Hospital for COPD: A Systematic Review

Cited by 6 publications

References 110 publications

Sprint Team Approach Yields Rapid Improvement in Leapfrog Quality Indicators

Sprint Team Approach Yields Rapid Improvement in Leapfrog Quality Indicators

ERS International Congress 2022: highlights from the Respiratory Clinical Care and Physiology Assembly

Associations between outpatient care and later hospital admissions for patients with chronic obstructive pulmonary disease - a registry study from Norway

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