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Preventing Readmission With COPD: Transition From Acute to Home Care

presented by Rebecca Crouch, Ellen Hillegass, and Kenneth L. Miller

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Disclosure Statement:

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.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact support@medbridgeed.com. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

Accreditation Check:
Readmission to the hospital for patients with COPD is a national concern. It is a problem for hospitals because it comes with a penalty from CMS if the readmission occurs within 30 days of discharge. Patients with COPD require monitoring beyond the acute care setting, and the current evidence supports continued monitoring of these patients beyond the acute care setting and the acute exacerbation. However, transition from the acute care setting to the home (or outpatient setting) is not always smooth, and communication is often lacking. This course will discuss the problem of readmission and transition of care, as well as the patient with COPD who is treated in the acute care setting and moves to the home setting. The identification of COPD patients at high risk for readmission will be discussed, along with the medications the patients may be sent home with and best practice for care in the home and outside the hospital.

Meet Your Instructors

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…

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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…

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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…

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Chapters & Learning Objectives

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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.

More Courses in this Series

Preventing Readmission With Heart Failure

Presented by Rebecca Crouch, PT, DPT, MS, CCS, FAACVPR, Ellen Hillegass, PT, EdD, CCS, FAPTA, and Kenneth L. Miller, PT, DPT, GCS, CEEAA

Preventing Readmission With Heart Failure

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Readmission to the hospital for patients with heart failure is a national concern. It is a problem for hospitals because it comes with a penalty from CMS if the readmission occurs within 30 days of discharge. Patients with heart failure require monitoring beyond the acute care setting, and current evidence supports continued monitoring of these patients beyond the acute care setting. However, transition from the acute care setting to the home (or outpatient setting) is not always smooth, and communication is often lacking.
This course will discuss the problem of readmission and transition of care, as well as how heart failure is treated in the acute care setting and moves to the home setting. The identification of heart failure patients at high risk for readmission will be discussed, along with the medications the patients may be sent home with and best practice for care in the home and outside the hospital.

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