Shared System of Care (COPD)

It’ll take your breath away

VIHA - Provincial Report Out

Trends in Age-standardized Death Rates (Percent change between 1970 and 2002) 2

What we did?

 Recruited 15 GPs & 6 MOAs in Comox Valley to attend a prototype for Shared System of Care (COPD)  Prototyped a model of two 3.5 hr. educational learning sessions and one action period  Action period work is designed to facilitate learning, testing tools and integrating changes into practice 3

12:00pm 12:30 1:15 1:45 1:55 2:40 2:50 3:10 3:40 3:50

AGENDA

Registration and Lunch

Welcome & Opening: Setting the Context – Why are we doing this?

Prevalence/Reviewing data Patho physiology of the disease Screening:  COPD-6 Demo & Video o Table breakout: Practice with using COPD-6 BREAK (Note: MOAs breakout until 2:40) Diagnosis  ABCs of PFT BREAK (Note: MOAs return) Respirology Department  Services Available  Referral to PFT Lab  Referral to Specialists Smoking Cessation: Strategies & Tools/Video to support

Action Period Measures

Evaluations and Close 4

AIM To create a system of care that improves the quality of care and experience for patients at risk for and living with COPD 5

How will we achieve this aim?

 Earlier identification of patients with COPD  Supporting patients to quit smoking  Enhancing patient self-management skills to manage their condition  Referring patients to appropriate community services and resources  Improving the patient experience with the system of care 6

Action Period Measurement 1.

2.

3.

4.

5.

Development of a COPD registry 10 screenings using COPD 6 10 smoking cessation interventions 3-5 COPD exacerbation plans Review, use if possible new referral form and provide feedback at Learning Session #2 Note: For #2-4 can be different patients 7

AP1 - COPD Data Collection Sheet  Please fill this form out and return via fax to Kate 8

Stepped Approach to Care 9

Screening – COPD-6 USB  The Vitalograph COPD-6 USB used for initial screening.  Benefits include: › › › Reliable test Ease of use Data download capability 10

COPD-6 Movie 11

St. Joseph’s General Hospital Respiratory Department Craig Dickson, RRT 12

ABCs of PFT

 Normal FVC=100% FEV1=80% FEV6=90% FEV1/FEV6=85%  Moderate COPD FVC=80% FEV1=70% FEV6=80% FEV1/FEV6=65%  Severe COPD FVC=65% FEV1=50% FEV1/FEV6=60% 13

St.Joseph’s PFT • Referral process • Testing options for COPD • Contraindications • Wait times • Interpretations • ABCs of PFT 14

GP Respirology Referral Form The cohort will trial this form over the Action Period .

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Smoking Cessation Derek Poteryko, M.D.

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Session Objectives 1.

How to approach and discuss smoking cessation with a smoker at the various stages of change 2.

Understand the efficacy of the most common cessation strategies 3.

Be aware of the various community resources for smoking cessation 4.

Be able to offer a timely and effective smoking intervention 17

Evaluations

Confidence in referring, communicating with Respirologists

No change; 4; 29% Increased; 10; 71%

Confidence in screening for COPD

No change; 0; 0% Decreased; 0; 0%

Tools, strategies and resources introduced in LS will be helpful in supporting patients with COPD

No 0% N/a 0% Increased; 24; 100% Yes 100% 18

Format of COPD Learning Session

Poor; 0; 0% Fair; 0; 0% Exceptional; 6; 25% Good; 3; 12% Very good; 15; 63%

Interactivity of COPD Learning Session

Poor; 0; 0% Fair; 0; 0% Good; 1; 4% Exceptional; 9; 38% Very good; 14; 58%

Content of COPD Learning Session

Poor; 0; 0% Fair; 0; 0% Good; 2; 8% Exceptional; 8; 33% Very good; 14; 59%

Overall Rating of COPD Learning Session

Poor; 0; 0% Fair; 0; 0% Good; 3; 12% Exceptional; 9; 38% Very good; 12; 50% 19

Questions?

20