ATS: Reduce COPD Readmission Rates Through Better Communication

To reduce the number of hospital readmissions of patients with chronic obstructive pulmonary disease (COPD), hospitals need more well-rounded interventions, better communication between patients and their providers, and identification of risk factors for readmission, according to a new report from the American Thoracic Society (ATS).

During an official ATS workshop at the 2016 ATS International Conference, a diverse group of clinicians, researchers, payers, and program leaders from across the country gathered to determine approaches that could be most successful in driving down COPD readmission rates.

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The workshop report was created in response to the trend that many US hospitals have developed and implemented programs to reduce admissions and readmissions of acute exacerbations of COPD, even though there was a lack of published evidence that shed light on what an effective hospital-based program should be.

By evaluating current evidence, the team described the best practices and models for how readmissions of acute exacerbations of COPD could be reduced.

The first area identified was the need for better communication.

“Communication is critical,” the team wrote. “Our patient and patient advocate stakeholders identified that poor communication at the time of diagnosis, care transitions, and clinical deterioration leads to a worsened patient experience and poor outcomes.”

Implementing holistic interventions, such as patient education and behavior modification through health coaching; addressing the multimorbidity and social determinants of health; using randomized schemas or other high-quality program evaluation designs; and identifying risk factors for readmission and/or high-risk patients are other ways the team says COPD readmission rates can be lowered.

The workshop group also recommended that programs address quality of care, not just quantity of readmissions

“The 30-day readmission metric may not be the most salient measure; the timeframe may need to be adjusted, and additional metrics needed to show whether hospital-based interventions improve COPD care and impact patient-centered outcomes, such as mortality, patient satisfaction, adherence, self-efficacy, symptoms, and exercise tolerance,” the team wrote.

—Colleen Murphy

Reference:

Press VG, Au DH, Bourbeau J, et al. Reducing chronic obstructive pulmonary disease hospital readmissions. An official American Thoracic Society workshop report. published online February 1, 2019]. Ann Am Thoracic Soc. https://doi.org/10.1513/AnnalsATS.201811-755WS.