Building Healthier Lives Improving quality of COPD care

Building Healthier Lives Improving quality of COPD care through digital education Heartlands Hospital Heart of England NHS Foundation Trust

Who are we? � HEFT � 3 hospital sites � Heartlands � Solihull � Good Hope � 1800 AECOPD admissions pa � Heartlands � High levels of deprivation � Ethnic diversity

Problems: 2014 audit at Heartlands � Poor levels of smoking cessation advice � 68% had a smoking status documented � 42% of active smokers were given cessation advice � Pulmonary rehabilitation � 17% had documents showing that rehab was considered � Of these most were referred but not all, and most referrals were made by COPD CNS � Enabling � 4% patients to self-care had inhaler technique check, 19% had selfmanagement plan

What was our solution? � Discharge care bundle Respiratory review Smoking cessation Inhaler technique Self management plan Pulmonary rehabilitation � SDIP 2014 -15 � CQUIN 2015 -16

Getting the bundle implemented � CNS and respiratory team v wider hospital team � Education � Mandatory for all band 6 ward nurses on selected wards � Mandatory for all physios and pharmacists on resp wards � Mixed methods of education � Ad hoc on wards � Group training � E-learning

The e-learning platform � Moodle � Modules require support from HEFT faculty � Can be accessed as many times as desired � MCQ must be done at least once � System logs access to the courses monthly & reports to users � Inhaler technique videos � Smoking cessation Podcast and slides � Pulmonary rehabilitation videos and app

Private You. Tube channel

Results 2014 -15 � SDIP targets � Data collection � Electronic where possible � Manual notes review Baseline Heartlands 23% Solihull 4% Good Hope 7% Q 4 50% 30% 65% Baseline Heartlands 28% Solihull 14% Good Hope 36% Q 4 82% 0%* Baseline Heartlands 6% Solihull 0 Good Hope 0 Q 4 62% 27% *Only 1 current smoker 56% 42%

Results 2015 -16 � CQUIN focussed on AECOPD admissions >48 hours in duration � Smoking cessation � ≥ 90% all sites � PR � 100% � Inhaler � ≥ 80% all sites technique Heartlands and Solihull � 47% Good Hope

Side effects of success � Waiting list for rehabilitation much longer � Now 25/52 on average to get into a class! � Solutions � Expansion to community sites � Business case for new staff � Home ‘app’ to expand from lung cancer to other conditions � Buddy programme for patient-patient education

What next? � Expanding training � Community pharmacists � Third sector Ri. PPLE project Admission bundle pilot at Solihull � QR code pilot on patients discharge medication �

Thankyou! � This project would not have been possible without our fantastic COPD MDT � Nursing: Pamela Sweeney, Karen Ebbon, Kirsty Russell, Tracey Stuart, Katie Neighbour, Emma Briggs…. � Physio: Stuart Lightfoot, Helen Beadle, Jan Mc. Gowan � Pharmacy: Baljit Ahitan � HEFT Faculty: Simon Potter Building Healthier Lives