Reducing avoidable COPD emergency presentations: An integrated cross-health service initiative

Grant ID: EMSS-364R28-2017

Project Summary

Almost 3% of consumers of healthcare services in the Darling Downs, West Moreton and Gold Coast (Including Robina) regions are estimated to have Chronic Obstructive Pulmonary Disease (COPD); which is somewhat higher than the state average of 2.4%. COPD is the second leading cause of avoidable hospital admissions. Anecdotal evidence indicates continued over-utilisation of frontline resources (e.g., Emergency Department [ED]), and potential gaps in outreach services (e.g. underutilised services).

This project will inform the implementation and evaluation of referral treatment initiatives (e.g., anxiety management, smoking cessation referral, and quality intra-professional care [IPC] programs), based on identified causal factors.

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Outcomes

This project sought to understand the major contributors surrounding Chronic Obstructive Pulmonary Disease (COPD) presentation in South Queensland emergency departments (ED), in order to develop a baseline measure for future research intervention.

Researchers conducted qualitative interviews with staff and patients, a scoping review, a data summary of COPD admissions, and a health economic analysis of ED presentation cost at three Queensland Health sites.

The total cost of COPD patients’ hospital stay was $42.14 million for the time period 2016-2018. Patient age and time spent in the ED were significantly associated with hospital length of stay, with older adults were reported as having a higher risk of re-presentation to the ED. Results also revealed several areas worthy of future research, one of which is the introduction of Nurse Case management for patients presenting with COPD.

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Dissemination

Moloney, C., Gow, J., Beccaria, G., Mullens, A., Phillips, T., Issac, H., King, A., Keijzers, G., Rana, R., 2023. Understanding COPD Emergency Department presentations: using thematic analysis to explore the voices of patients, nurses, and doctors on the lived experience of managing COPD. AJAN-The Australian Journal of Advanced Nursing, 40(1). https://doi.org/10.37464/2023.401.195

Rana, R., Gow, J., Moloney, C., King, A., Keijzers, G., Beccaria, G. and Mullens, A., 2021. Estimating the frequency and cost of emergency department presentations and hospitalisation of chronic obstructive pulmonary disease patients: A retrospective analysis from regional Queensland. Emergency Medicine Australasia, 33(3), pp.491-498.

Issac, H., Moloney, C., Taylor, M. and Lea, J., 2020. Mapping of modifiable barriers and facilitators with interdisciplinary chronic obstructive pulmonary disease (COPD) guidelines concordance within hospitals to the theoretical domains framework: a mixed methods systematic review protocol. BMJ open, 10(7), p.e036060.

Moloney, C., Beccaria, G., Mullens, A., Issac, H. and Phillips, T., 2019. Recommendations and practices for holistic (COPD) assessment and optimal referral patterns in emergency department presentations: a scoping review protocol study. BMJ Open, 9(Article e30358), pp.1-5.

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Video/Presentations

Clint Moloney. Poster Discussion Presentation(s) at the TSANZSRS Annual Scientific Meeting 2020, to be held at the Melbourne Convention and Exhibition Centre from 27 - 31 March 2020.

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