by Amber Romstad Hanser, MHA, CPHQ
Performance Improvement Program Director

On a recent visit to see his elderly mother, a son finds her struggling to breathe. She lives on the second floor of her apartment building and while she is able to walk, she can’t navigate the stairs and he’s unable to carry her. Getting her to the doctor presents a logistical challenge, making it difficult to manage her chronic obstructive pulmonary disease (COPD) and increases the risk of exacerbation. He feels helpless and scared.

Chronic obstructive pulmonary disease is a long-term lung disease that includes serious respiratory illnesses such as emphysema, bronchitis and refractory (non-reversible) asthma. These chronic illnesses can be managed with appropriate and timely treatments, but without can often lead to exacerbations and hospitalizations. A leading cause of death in the United States, COPD affects 16 million Americans. More than 65 million people around the world have moderate or severe COPD, and experts predict that this number will continue to rise worldwide over the next 50 years. In 2010 this disease cost $30 billion a year in health care expense in this country and is expected to reach $60 billion by the year 2020.

The right call

Thankfully for this man, his mother’s doctor has a service for patients to connect with a practitioner 24 hours a day, 7 days a week when assistance is needed. One of the primary purposes of this service is to help patients like her manage their COPD.

In this situation, when the son made the call, his mother was in crisis and needed to get to a hospital as soon as possible. Unfortunately, the nearest facility was not her preferred hospital and she initially resisted being hospitalized there. But the son remained in contact with the physician and the appropriate transfers were ultimately made a few days later when she returned to their emergency department and agreed to be admitted, pending transfer to her preferred hospital. Because the son acted quickly to utilize this service, he possibly saved his mother’s life and certainly got her the care she needed.

The physician, who answered the calls from the son that weekend, explained that the service is designed in such a way that the patient’s autonomy and personal choices are respected. The other aspect is to ensure that the patient makes an informed choice, so critical information and full transparency of the plan of care is shared with the patient.

Working together for solutions

The call service in this story is one of the valuable strategies that was shared during a recent Vizient performance improvement collaborative focusing on COPD. Vizient is currently in the middle of a two-part COPD Chronic Care Management collaborative aimed at enabling 50 participating hospitals and health care organizations to collectively work on improving patient navigation through various care access points, improve patient outcomes and increase community education, awareness and overall support for the COPD patient population.

Participating organizations are currently working to implement effective COPD care management strategies, standard practices of care and evidence based protocols to help reduce disease progression, process variation and COPD-related emergency department visits and readmissions. This project will conclude in 2020.

The Vizient Performance Improvement Collaboratives program provides an opportunity for network members to come together with clinical, operational and quality leaders to work on the most critical aspects of health care performance. Through collaboration and the sharing of leading practices, participants are able to improve quality of care, lower costs and increase efficiency. To learn more about the Vizient collaboratives programs, contact us today.

About the author. In her role as program director on the Vizient Performance Improvement Collaboratives team, Amber Romstad Hanser develops, manages and delivers national performance improvement projects, while publishing leading strategies, cutting-edge research, relevant data, and actionable insights to help more than 460 member organizations deliver exceptional care.

Published: November 22, 2019