Improving the care of patients with Chronic Obstructive Pulmonary Disorder (COPD) Royal United Hospital, Bath, NHS Trust

Royal United Hospital aimed to further develop their service for patients with COPD, so that patients can be discharged earlier and both patients and their carers are adequately supported in the community.

The main objectives for the project were:

• patients receiving Non-Invasive Ventilation (NIV) for COPD exacerbations cared for on the Respiratory Ward within 24 hours of use of NIV
• emergency oxygen prescribed and appropriately administered for patients with COPD
• improving patient education through the use of patient information leaflets, inhaler training guides and appointments for smoking cessation/pulmonary rehabilitation
• improving communication with primary care when patients leave hospital to prevent unnecessary re-admission
• recognising the importance of special nutritional needs for these patients by ensuring nutrition screening is undertaken and patients with a low body mass index receive dietetic input or nutritional supplements during their hospital stay.

They created a COPD discharge bundle to remind staff of the support patients need prior to discharge. This included:

• a referral to the Healthy Lifestyle Service
• a follow up appointment with the GP
• attendance at pulmonary rehabilitation clinics
• use of inhalers
• information leaflets on how to stay healthy.

As part of the project, the team worked to improve the information on COPD for carers and increased the involvement of carers at consultations. They used shadowing and patient questionnaires to ensure patients and carers input into the improvements.

Who was involved?

A multi-disciplinary project team from the respiratory ward led the project. Their success depended on close partnership with teams providing complimentary services like the ‘Impact Team’ who provide a ‘hospital at home’ service for people with COPD and work to prevent hospital admissions.