PRAXIS Resource of the Month: SHM COPD Implementation Guide

This post was written by Kristen Willard, M.S.

This toolkit is designed to help clinicians, medical directors and healthcare administrators improve the care of patients who are hospitalized for an exacerbation of chronic obstructive pulmonary disease.

At 180 pages, the toolkit is an extensive collection of guidelines and best practices that includes the following areas:

• Successful multidisciplinary team development and role delineation, to include not only front-line healthcare providers but invested administration team members;
• Completing a needs assessment, stakeholder analysis and a systematic examination of the current state of your COPD program;
• Achieving accurate and prompt diagnosis in symptomatic patients via spirometry;
• Management of stable COPD, prevention and management of exacerbations, and reduction of additional lung damage due to smoking and exposure to other toxins;
• Determining individual patient baseline status as well as completing risk stratification;
• Pharmocologic and non-pharmacologic treatments, including oxygen therapy, smoking cessation, immunizations and breathing techniques;
• Guidelines on the use of both non-invasive and invasive ventilation;
• Approaches to minimizing hospital-acquired conditions;
• Assessing and addressing COPD comorbitidies such as nutritional issues, obstructive sleep apnea, cardiovascular disease and psychiatric disorders;
• Palliative and end-of-life care, encouraging patient-centered dialogue and open communication regarding patient experiences to date, goals, expectations and provider recommendations;
• Improving transitions of care, including the incorporation of medication reconciliation, pulmonary rehabilitation and patient and family education and self-management support. Effective communication between hospital staff and post-acute care providers is also highlighted.

There is also a robust section devoted solely to developing and implementing evidence-based interventions based upon these best practices. Importantly, the toolkit encourages both baseline and ongoing data collection and outlines what factors you may want to measure when gauging the effectiveness of any quality improvement initiative.

The inclusion of relevant models, checklists and tools will be particularly helpful for those looking to create a full program or to expand or enrich an existing approach; all of the tools can be extracted and modified to fit the needs of your particular organization.

Particular resources of note include:

• An example process map documenting the participants and key treatments and decisions at each phase of hospitalization (pages 14-15);
• Delineated guidelines for developing and implementing a sound medication reconciliation process (pages 79-82);
• Resource tables for health literacy (pages 89-90) as well as patient education and self-management (pages 93-95) and device education (pages 96-97);
• A draft COPD order set (pages 127-129).

We hope you find this to be a useful resource. 

If you have used the SHM toolkit, let us know your thoughts in the comments below! If this toolkit is new to you, what aspects might you incorporate into your COPD care approach?

This page was reviewed on March 5, 2020 by the COPD Foundation Content Review and Evaluation Committee