Sarah Buckley, Respiratory Clinical Nurse Consultant:  COPD or chronic obstructive pulmonary disease is actually an umbrella term for different types of respiratory conditions like emphysema or chronic bronchitis or chronic asthma. There is an obstruction in their breathing tests that is no longer fully reversible.  

Elke Lappan, Patient:  I have been diagnosed now with COPD. I couldn't breathe. I was having anxiety attacks, you get panicky. It just absorbs you totally.

Sarah Buckley, Respiratory Clinical Nurse Consultant:  Leading Better Value Care has been an interesting journey for us. We had our audit about two years ago and it highlighted areas for us that we were doing really well with, but it highlighted we had some areas for growth and improvement.
Dr Diane Watson, Chief Executive Bureau of Health Information:  When we look at 30-day mortality rates for patients who have lung disease COPD, we do find that there are a lot of opportunities across the state for hospitals to learn from each other.
As an example with COPD, we do find that there was about ten hospitals whose mortality rates for patients were much higher than we would expect. At the same time, there are leading hospitals in the state, two of them where we saw mortality rates much much lower than we would have expected.
Clearly opportunities across the state for us to share good practices, learn to provide better value to patients and reduce outcomes that we don't want, which is 30-day mortality rates.
Sarah Buckley, Respiratory Clinical Nurse Consultant:  As a team we started looking at what we could do with that data and how we could use that to guide more focused change management within our environment.
It's giving us an honest result on areas we can improve and I suppose it's language, there's a lot of language and communication that comes into trying to make Leading Better Value Care work. Like it is in any area in clinical practice when you want to make change or review a process.
The fact that I had just come through a winter period and I knew the volume of patients I was seeing every day, but that that wasn't reflected in the audit did surprise me and it made me think what can I do different, what was causing that audit result?
Elke Lappan, Patient:  We have one day a week in our instruction program where they explain the use of the inhalers, the use of the various medication, emergency charts, then you make yourself a program as to the exercises you do at home and they check you up on that to see if you can pedal a bit faster.
And what I admire most about all the staff, whether it's support staff or the talk staff or physios, how calm and friendly, it doesn't matter how you're puffing and carrying on, 'keep going, keep going, you're doing fine haha'.
So, encouragement all the way. You know what to do with the action plan, I know if I get into trouble, I know exactly the next four steps you have to take before you contact your doctor and then it's all go.
Sarah Buckley, Respiratory Clinical Nurse Consultant:  To hear patients then feedback to me when I see them and them telling me how ‘oh I was unwell when I started my action plan the other day and oh you know I know I got a bit crook but I did really well and I really I understand what I need to do now’.
I think the biggest thing that I can see is that we've opened a conversation, that we've increased awareness of the risks and issues that we have with this group.
We're not very good at celebrating in Health, we're really good at looking at how can we do it better and we need to work better next time and, you know, what didn't we do right rather than saying we just did a really good job then and look at that improvement and celebrate the patient stories that we're getting back as a result of the change we've made.

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Current as at: Thursday 16 April 2020
Contact page owner: Strategic Reform and Planning