Hillegass: PT Cardiopulmonary Educators: web-based continuing education program partners Cardiopulmonary Specialists: a consulting company CEO Speaker for Genentech: a pharmaceutical company Receives Royalties: Essentials of Cardiopulmonary Physical Therapy and Rehab Notes Crouch: -PT Cardiopulmonary Educators (Partners) -Cardiopulmonary Therapy Research (CEO) Miller: Financial— Kenneth Miller receives compensation from MedBridge for the production of this course. There are no other relevant financial relationships. Nonfinancial— No relevant nonfinancial relationship exists.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
Rebecca Crouch, PT, DPT, MS, CCS, FAACVPR
Dr. Rebecca Crouch has practiced cardiovascular and pulmonary physical therapy in the acute care and outpatient rehabilitation settings, and was a founding member and director of the Duke University pulmonary rehabilitation outpatient program for 30 years. She is now an assistant professor in the Doctor of Physical Therapy program at Campbell University, and her clinical…Read full bio
Ellen Hillegass, PT, EdD, CCS, FAPTA
Dr. Ellen Hillegass is a physical therapist with APTA board certification in cardiovascular and pulmonary clinical specialty. She currently holds the position of adjunct professor in the departments of physical therapy at Mercer University in Atlanta and Western Carolina University in Cullowhee, NC. Ellen is also the president and CEO of Cardiopulmonary Specialists, a private…Read full bio
Kenneth L. Miller, PT, DPT, GCS, CEEAA
Dr. Kenneth Miller has been an educator, physical therapist, and consultant for the home health industry for more than 20 years and serves as a guest lecturer, adjunct teaching assistant, and adjunct professor in the DPT program at Touro College in Bay Shore, New York. He has presented at the Combined Sections Meeting of the…Read full bio
1. Overview of the Problem: Readmission and Transition-of-Care Issues
CMS has started to penalize hospitals for patients with COPD who are readmitted within 30 days of discharge. Therefore, hospitals have been searching for ways to prevent readmissions. Identifying high-risk patients and developing post-hospital transition programs have become the norm to assist with decreasing readmissions. The evidence on predictors of readmission is discussed; this evidence lays the foundation for this course.
2. COPD: The Diagnosis, Diagnostic Tests, Symptoms, Medications, and Treatment
The physical therapist must be familiar with the typical pathophysiological characteristics and presentation of the COPD patient. Common tests used for COPD diagnosis are adequate to detect moderate to advanced disease but may not be specific enough to detect early stages of COPD. Common medications exist for the relief of symptoms of COPD, but there are no known curative or preventive medications.
3. Treatment of the Acute Exacerbation in the Acute Care and Home Care Settings
Starting with the case of a patient with an acute exacerbation, discussion centers around the treatment of the patient while an inpatient, including the medical management and physical exercise needed. This section discusses the inpatient experience, up to and including the discharge expectations.
4. Role of Oxygen With COPD
Supplemental oxygen is known to improve survival and quality of life in patients with significant resting and exercise hypoxemia. The benefit of supplemental oxygen is less clear for those with minimal to moderate hypoxemia at rest or with exercise. New evidence addressing oxygen supplementation will be discussed.
5. What About After the Acute Care Admission? What Is the Transition to Home Care?
Many patients discharged home from an acute hospital admission for COPD have exacerbations that are not fully resolved at the time of discharge, which increases the risk of rehospitalization. Transitioning home is a vulnerable time point that requires appropriate handoff of information between practice settings and the patient. Coaching, discharge management, and patient self-management are key to reducing readmissions.
6. Home Care Programs for the Patient With COPD: Best Practice Utilizing the ICF Model
Patient engagement and activation to increase adherence to medication regime, physical activity, smoking cessation, and self-monitoring for decompensation are best practices to reduce re-hospitalization risk. Providing education in self-management of medications, including oxygen and activity level will be explored to reduce rehospitalization risk. Providing education in self-management of medications (including oxygen) and activity level to reduce rehospitalization risk will be explored.