Quality of COPD care in hospital outpatient clinics in Denmark: The KOLIBRI study

Peter Lange; Klaus Kaae Andersen; Erik Munch; Tina Brandt Sørensen; Jens Dollerup; Kirsten Kassø; Hanne Bormann Larsen; Ronald Dahl

doi:10.1016/j.rmed.2009.05.010

Quality of COPD care in hospital outpatient clinics in Denmark: The KOLIBRI study

Peter Lange, Klaus Kaae Andersen, Erik Munch, Tina Brandt Sørensen, Jens Dollerup, Kirsten Kassø, Hanne Bormann Larsen, Ronald Dahl

21 Citations (Scopus)

Abstract

BACKGROUND: We studied the quality of care for COPD patients in 22 hospital-based outpatient clinics in Denmark and evaluated if participation by the staff in an educational programme could improve the quality of care and adherence to the COPD guidelines. METHODS: We performed two audits of the hospital records one year apart before and after the educational programme for the participating doctors and nurses. A total of 941 patient records were included in the first audit and 927 in the second. The indicators of quality of care comprised amongst others referral to pulmonary rehabilitation, smoking cessation advice, nutritional advice, instruction in inhalation technique and assessment of BMI, smoking status, pack years, lung function parameters, dyspnoea oxygen saturation and co-morbidities. RESULTS: In general, the quality of care for COPD patients in Denmark was suboptimal and not in accordance with the recently published guidelines both in the 1st and the 2nd audit. Yet, we observed a substantial improvement from the 1st to the 2nd audit. For example, referral to rehabilitation improved from 56.3 to 62.7% (p=0.006) Assessment of BMI improved from 7.8 to 56.1% and assessment of dyspnoea using MRC dyspnoea scale increased from 7.2 to 47.2% (both p<0.001). When analysing the results with focus on the performance of the individual outpatient clinics we also observed an improvement in the quality. CONCLUSION: We conclude that it is possible to improve the quality of care for COPD by focusing on a more systematic approach to the patient assessment by education of the staff of the outpatient clinics. A repeated and continuous education and discussion with the clinical staff is probably essential to reach an acceptable level of the quality of care for outpatients with COPD.

Original language	English
Journal	Respiratory Medicine
Volume	103
Issue number	11
Pages (from-to)	1657-62
Number of pages	6
ISSN	0954-6111
DOIs	https://doi.org/10.1016/j.rmed.2009.05.010
Publication status	Published - 2009

Access to Document

10.1016/j.rmed.2009.05.010

Cite this

@article{2248d750747c11df928f000ea68e967b,

title = "Quality of COPD care in hospital outpatient clinics in Denmark: The KOLIBRI study",

abstract = "BACKGROUND: We studied the quality of care for COPD patients in 22 hospital-based outpatient clinics in Denmark and evaluated if participation by the staff in an educational programme could improve the quality of care and adherence to the COPD guidelines. METHODS: We performed two audits of the hospital records one year apart before and after the educational programme for the participating doctors and nurses. A total of 941 patient records were included in the first audit and 927 in the second. The indicators of quality of care comprised amongst others referral to pulmonary rehabilitation, smoking cessation advice, nutritional advice, instruction in inhalation technique and assessment of BMI, smoking status, pack years, lung function parameters, dyspnoea oxygen saturation and co-morbidities. RESULTS: In general, the quality of care for COPD patients in Denmark was suboptimal and not in accordance with the recently published guidelines both in the 1st and the 2nd audit. Yet, we observed a substantial improvement from the 1st to the 2nd audit. For example, referral to rehabilitation improved from 56.3 to 62.7% (p=0.006) Assessment of BMI improved from 7.8 to 56.1% and assessment of dyspnoea using MRC dyspnoea scale increased from 7.2 to 47.2% (both p<0.001). When analysing the results with focus on the performance of the individual outpatient clinics we also observed an improvement in the quality. CONCLUSION: We conclude that it is possible to improve the quality of care for COPD by focusing on a more systematic approach to the patient assessment by education of the staff of the outpatient clinics. A repeated and continuous education and discussion with the clinical staff is probably essential to reach an acceptable level of the quality of care for outpatients with COPD.",

author = "Peter Lange and Andersen, {Klaus Kaae} and Erik Munch and S{\o}rensen, {Tina Brandt} and Jens Dollerup and Kirsten Kass{\o} and Larsen, {Hanne Bormann} and Ronald Dahl",

year = "2009",

doi = "10.1016/j.rmed.2009.05.010",

language = "English",

volume = "103",

pages = "1657--62",

journal = "Respiratory Medicine",

issn = "0954-6111",

publisher = "Elsevier",

number = "11",

}

TY - JOUR

T1 - Quality of COPD care in hospital outpatient clinics in Denmark: The KOLIBRI study

AU - Lange, Peter

AU - Andersen, Klaus Kaae

AU - Munch, Erik

AU - Sørensen, Tina Brandt

AU - Dollerup, Jens

AU - Kassø, Kirsten

AU - Larsen, Hanne Bormann

AU - Dahl, Ronald

PY - 2009

Y1 - 2009

N2 - BACKGROUND: We studied the quality of care for COPD patients in 22 hospital-based outpatient clinics in Denmark and evaluated if participation by the staff in an educational programme could improve the quality of care and adherence to the COPD guidelines. METHODS: We performed two audits of the hospital records one year apart before and after the educational programme for the participating doctors and nurses. A total of 941 patient records were included in the first audit and 927 in the second. The indicators of quality of care comprised amongst others referral to pulmonary rehabilitation, smoking cessation advice, nutritional advice, instruction in inhalation technique and assessment of BMI, smoking status, pack years, lung function parameters, dyspnoea oxygen saturation and co-morbidities. RESULTS: In general, the quality of care for COPD patients in Denmark was suboptimal and not in accordance with the recently published guidelines both in the 1st and the 2nd audit. Yet, we observed a substantial improvement from the 1st to the 2nd audit. For example, referral to rehabilitation improved from 56.3 to 62.7% (p=0.006) Assessment of BMI improved from 7.8 to 56.1% and assessment of dyspnoea using MRC dyspnoea scale increased from 7.2 to 47.2% (both p<0.001). When analysing the results with focus on the performance of the individual outpatient clinics we also observed an improvement in the quality. CONCLUSION: We conclude that it is possible to improve the quality of care for COPD by focusing on a more systematic approach to the patient assessment by education of the staff of the outpatient clinics. A repeated and continuous education and discussion with the clinical staff is probably essential to reach an acceptable level of the quality of care for outpatients with COPD.

AB - BACKGROUND: We studied the quality of care for COPD patients in 22 hospital-based outpatient clinics in Denmark and evaluated if participation by the staff in an educational programme could improve the quality of care and adherence to the COPD guidelines. METHODS: We performed two audits of the hospital records one year apart before and after the educational programme for the participating doctors and nurses. A total of 941 patient records were included in the first audit and 927 in the second. The indicators of quality of care comprised amongst others referral to pulmonary rehabilitation, smoking cessation advice, nutritional advice, instruction in inhalation technique and assessment of BMI, smoking status, pack years, lung function parameters, dyspnoea oxygen saturation and co-morbidities. RESULTS: In general, the quality of care for COPD patients in Denmark was suboptimal and not in accordance with the recently published guidelines both in the 1st and the 2nd audit. Yet, we observed a substantial improvement from the 1st to the 2nd audit. For example, referral to rehabilitation improved from 56.3 to 62.7% (p=0.006) Assessment of BMI improved from 7.8 to 56.1% and assessment of dyspnoea using MRC dyspnoea scale increased from 7.2 to 47.2% (both p<0.001). When analysing the results with focus on the performance of the individual outpatient clinics we also observed an improvement in the quality. CONCLUSION: We conclude that it is possible to improve the quality of care for COPD by focusing on a more systematic approach to the patient assessment by education of the staff of the outpatient clinics. A repeated and continuous education and discussion with the clinical staff is probably essential to reach an acceptable level of the quality of care for outpatients with COPD.

U2 - 10.1016/j.rmed.2009.05.010

DO - 10.1016/j.rmed.2009.05.010

M3 - Journal article

C2 - 19520562

SN - 0954-6111

VL - 103

SP - 1657

EP - 1662

JO - Respiratory Medicine

JF - Respiratory Medicine

IS - 11

ER -

Quality of COPD care in hospital outpatient clinics in Denmark: The KOLIBRI study

Abstract

Access to Document

Fingerprint

Cite this