Improving the quality and safety of care continues to be a key strategic direction for Providence Health Care (PHC). To help achieve this strategic direction, PHC has launched the COPD (chronic obstructive pulmonary disorder) Outreach Program, a pilot project helping people transition from hospital to their home/community following a hospitalization due to an acute COPD exacerbation. People hospitalized at St. Paul’s or Mount Saint Joseph Hospital due to an acute exacerbation of their COPD are eligible for this program.
What does the COPD Outreach Program do?
It is important that people living with COPD know how to best self-manage their condition. To achieve this, patients admitted to hospital due to exacerbation of their COPD need to have appropriate supports to successfully transition back to their home/communities and have the knowledge to best manage their condition.
The COPD Outreach Program emphasizes education and self-management, as well as ongoing monitoring to ensure discharged clients continue to do well at home or in their community.
Clients are be supported by an interdisciplinary team of health care professionals. The focus of this program is short-term intensive support, with an emphasis on linking clients back with their primary care physician and COPD supports available in the community. Clients are followed for a maximum of 3 months following hospital discharge.
With enhanced transition support and communication/care coordination with community health services and specialists (e.g. VCH health units, mental health teams, family doctors), we anticipate that people living with COPD will experience better health outcomes and an improved understanding of their disease. As a result, we also anticipate a reduction in hospital admissions and emergency department visits.
The COPD Outreach Program is part of a VCH/PHC regional initiative to support the transition from hospital to home for people living with chronic disease. VCH – Richmond, Coastal and Vancouver are also participating in this project, and, in addition to COPD outreach, will also offer outreach services for stroke and congestive heart failure.
This pilot project will continue until end of Summer 2012. At that point, the project data will be analyzed to see if there was an impact on the health outcomes of people with COPD, and if there was a difference in their average length of stay and hospital readmission/emergency room visits.
Want to learn more?
To learn more about the COPD Outreach Program or to refer a client, contact us at COPD@providencehealth.bc.ca or (604) 682-2344 ext 62247.