Chronic obstructive pulmonary disease in adults

Process

a) Proportion of people discharged from hospital after an acute exacerbation of COPD who understand their medication and inhaler use.

Numerator – the number in the denominator who understand their medication and inhaler use.

Denominator – the number of people discharged from hospital after an acute exacerbation of COPD.

Data source: COPD secondary care reports of the Royal College of Physicians National Respiratory Audit Programme include data on people who have their medication assessed and inhaler technique checked at discharge from hospital after a COPD exacerbation.

b) Proportion of people discharged from hospital after an acute exacerbation of COPD who receive a self-management plan.

Numerator – the number in the denominator who receive a self-management plan.

Denominator – the number of people discharged from hospital after an acute exacerbation of COPD.

Data source: COPD secondary care reports of the Royal College of Physicians National Respiratory Audit Programme include data on people who have received a self-management plan at discharge from hospital after a COPD exacerbation.

c) Proportion of people discharged from hospital after an acute exacerbation of COPD who smoke and are referred to smoking cessation behavioural change.

Numerator – the number in the denominator who are referred to smoking cessation behavioural change.

Denominator – the number of people discharged from hospital after an acute exacerbation of COPD who smoke.

Data source: COPD secondary care reports of the Royal College of Physicians National Respiratory Audit Programme include data on people who are referred to smoking cessation behavioural change at discharge from hospital after a COPD exacerbation.

d) Proportion of people discharged from hospital after an acute exacerbation of COPD whose condition is assessed for pulmonary rehabilitation suitability.

Numerator – the number in the denominator whose condition is assessed for pulmonary rehabilitation suitability.

Denominator – the number of people discharged from hospital after an acute exacerbation of COPD.

Data source: COPD secondary care reports of the Royal College of Physicians National Respiratory Audit Programme include data on people whose condition is assessed for pulmonary rehabilitation suitability at discharge from hospital after a COPD exacerbation.

e) Proportion of people discharged from hospital after an acute exacerbation of COPD who receive follow-up within 72 hours.

Numerator – the number in the denominator who receive follow-up within 72 hours.

Denominator – the number of people discharged from hospital after an acute exacerbation of COPD.

Data source: COPD secondary care reports of the Royal College of Physicians National Respiratory Audit Programme include data on people who receive follow-up within 72 hours of discharge from hospital after a COPD exacerbation.

Outcome

a) Hospital readmissions for acute exacerbations.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

b) Mortality rates.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records.

Acute exacerbation

An exacerbation is a sustained worsening of a person's symptoms from their usual stable state, which is beyond usual day‑to‑day variations and is acute in onset. Commonly reported symptoms are worsening breathlessness, cough, increased mucus production and change in mucus colour.

Exercise capacity and physical activity levels are impaired during and after an exacerbation, which contributes to skeletal muscle dysfunction, particularly in the lower limbs. [Adapted from NICE's guideline on diagnosing and managing chronic obstructive pulmonary disease in over 16s, terms used in this guideline, and the British Thoracic Society's guideline on pulmonary rehabilitation in adults]

Hospital discharge care bundle

A hospital discharge care bundle is a group of evidence-based elements of ongoing care that should be implemented or checked, and verified, on discharge from hospital. The discharge bundle should cover the following:

[Adapted from NHS England's 2022/23 National Tariff Payment System, Annex C: Guidance on best practice tariffs]