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Meeting ReportPFTs, Pulmonary Disease, Homecare, and Equipment

The Impact of a Home Respiratory Care Practitioner to Reduce 30-day Readmission Rates for COPD Exacerbation

Monica Truumees, Moira Elizabeth Kendra, Stephanie Chiu, Danielle Tonzola, Rupal Mansukhani, Federico Cerrone, Beverly Natale, Daryl Rogers, Michael Squillante, Cristen Mackwell, Stephen Moran and Daniel Markley
Respiratory Care October 2020, 65 (Suppl 10) 3448019;
Monica Truumees
AtHome Medical, Atlantic Health System, Morris Plains, New Jersey, United States
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Moira Elizabeth Kendra
Pulmonary, Atlantic Health System, Morristown, New Jersey, United States
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Stephanie Chiu
Atlantic Health Center of Research, Morristown, New Jersey, United States
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Danielle Tonzola
Respiratory, Morristown Medical Center, Morristown, New Jersey, United States
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Rupal Mansukhani
Pharmacy, Morristown Medical Center, Morristown, New Jersey, United States
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Federico Cerrone
Pulmonary and Allergy Associates, Atlantic Health System, Morristown, New Jersey, United States
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Beverly Natale
Administration, Morristown Medical Center, Morristown, New Jersey, United States
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Daryl Rogers
AtHome Medical, Atlantic Health System, Morris Plains, New Jersey, United States
Administration, Eastern Christian Children's Retreat, Wykoff, New Jersey, United States
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Michael Squillante
Respiratory, Newton Medical Center, Newton, New Jersey, United States
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Cristen Mackwell
Nursing, Hackettstown Medical Center, Hackettstown, New Jersey, United States
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Stephen Moran
Atlantic Health System, Morristown, New Jersey, United States
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Daniel Markley
Pulmonary and Allergy Associates, Atlantic Medical Group, Cedar Knolls, New Jersey, United States
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Abstract

Background: In 2015, the Centers for Medicare and Medicaid Services (CMS) limit payments to hospitals with high readmission rates for patients admitted with acute exacerbation of COPD (AECOPD). Decreasing readmissions in this patient population improves patient health and decreases healthcare utilization of resources. We hypothesized a COPD Management Program (COPD-MP), delivered by a respiratory care practitioner (RCP) in the patient’s home would reduce readmission rates for AECOPD.

Methods: We performed a pre/post-intervention design study, comparing hospital readmissions for AECOPD patients who received standard of care in the home versus a RCP-led COPD-MP. From January 2016 to March 2017, patients discharged home from Atlantic Health System (AHS) with AECOPD were enrolled in the pre-intervention group. Subsequently, an evidence-based COPD-MP was implemented by an RCP from At Home Medical (AHM) in the home. The COPD-MP was implemented in the patient’s home from April 2017 until September 2019 and this served as the post-intervention group.

Results: A total of 835 patients were included in the pre-intervention cohort and 576 patients in the COPD-MP. There was a reduction in 30-day all cause readmission between the pre-intervention cohort and the COPD-MP cohort (17.6% vs. 11.3%, P=0.001). There was also a reduction in 60-day all cause readmissions (26% vs. 12.5%, P<0.001) and 90-day all cause readmissions (33% vs. 12.5%, P<0.001).

Conclusions: Utilizing an evidence-based RCP-led COPD-MP approach, in the post discharge period is crucial in preventing recurrent hospitalizations. This quality improvement project in COPD-MP established an innovative strategy implemented by an RCP in the discharge period to reduce readmission rates. A review of the data demonstrated a 35% reduction in 30-day readmissions when a COPD-MP was implemented in the patient’s home. There was also a reduction in 60-day and 90-day readmission by 52% and 62% respectively.

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Reduction in COPD Readmissions

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Respiratory Care
Vol. 65, Issue Suppl 10
1 Oct 2020
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The Impact of a Home Respiratory Care Practitioner to Reduce 30-day Readmission Rates for COPD Exacerbation
Monica Truumees, Moira Elizabeth Kendra, Stephanie Chiu, Danielle Tonzola, Rupal Mansukhani, Federico Cerrone, Beverly Natale, Daryl Rogers, Michael Squillante, Cristen Mackwell, Stephen Moran, Daniel Markley
Respiratory Care Oct 2020, 65 (Suppl 10) 3448019;

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The Impact of a Home Respiratory Care Practitioner to Reduce 30-day Readmission Rates for COPD Exacerbation
Monica Truumees, Moira Elizabeth Kendra, Stephanie Chiu, Danielle Tonzola, Rupal Mansukhani, Federico Cerrone, Beverly Natale, Daryl Rogers, Michael Squillante, Cristen Mackwell, Stephen Moran, Daniel Markley
Respiratory Care Oct 2020, 65 (Suppl 10) 3448019;
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