Reducing hospital admissions for COPD: perspectives following the Christchurch Earthquake

Resource type
Authors/contributors
Title
Reducing hospital admissions for COPD: perspectives following the Christchurch Earthquake
Abstract
The devastating 2011 earthquake in Christchurch destroyed or badly damaged healthcare infrastructure, including Christchurch Hospital. This forced change in management of exacerbations of chronic obstructive pulmonary disease (COPD), which until that point had frequently led to admission to hospital and focused attention on providing safe community options for care. This paper describes the process of understanding factors contributing to high admission frequency with exacerbations of COPD and also describes a process of change, predominantly to healthcare delivery systems and philosophies, and the subsequent outcomes. What became clear in understanding admissions with COPD to Christchurch Hospital was that the behaviour of the patient, in the context of exacerbations, and the subsequent response of the system to the patient, led to admission being the default option, in spite of low severity of the exacerbation itself. By altering systems’ responses to exacerbations, with a linked care process between ambulances, community care and hospitals, we were able to safely reduce admissions for COPD, with a sustained overall reduction in bed-day occupancy for COPD of ~48%. We would encourage these discussions and changes to occur without the stimulus of an earthquake in your healthcare environment!
Publication
BMJ Open Respiratory Research
Volume
5
Issue
1
Date
2018/08/01
Language
en
DOI
10.1136/bmjresp-2018-000286
ISSN
2052-4439
Short Title
Reducing hospital admissions for COPD
Accessed
2019-11-27T20:32:58Z
Library Catalog
Rights
© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Citation
Epton, M., Limber, C., Gullery, C., McGeoch, G., Shand, B., Laing, R., Brokenshire, S., Meads, A., & Nicholson-Hitt, R. (2018). Reducing hospital admissions for COPD: perspectives following the Christchurch Earthquake. BMJ Open Respiratory Research, 5(1). https://doi.org/10.1136/bmjresp-2018-000286
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