Shared System of Care (COPD)It’ll take your breath away

VIHA - Provincial Report Out

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

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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

What we did?

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AGENDA12:00pm Registration and Lunch

12:30 Welcome & Opening: Setting the Context – Why are we doing this?Prevalence/Reviewing dataPatho physiology of the disease

1:15 Screening: COPD-6 Demo & Video

o Table breakout: Practice with using COPD-6

1:45 BREAK (Note: MOAs breakout until 2:40)1:55 Diagnosis

ABCs of PFT2:40 BREAK (Note: MOAs return)2:50 Respirology Department

Services AvailableReferral to PFT LabReferral to Specialists

3:10 Smoking Cessation: Strategies & Tools/Video to support

3:40 Action Period Measures 3:50 Evaluations and Close

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

AIM

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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   

How will we achieve this aim?

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1. Development of a COPD registry2. 10 screenings using COPD 63. 10 smoking cessation interventions 4. 3-5 COPD exacerbation plans5. Review, use if possible new referral form and provide

feedback at Learning Session #2

Note: For #2-4 can be different patients

Action Period Measurement

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AP1 - COPD Data Collection Sheet

Please fill this form out and return via fax to Kate

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Stepped Approach to Care

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The Vitalograph COPD-6 USB used for initial screening.

Benefits include:› Reliable test› Ease of use› Data

download capability

Screening – COPD-6 USB

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COPD-6 Movie

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St. Joseph’s General Hospital Respiratory Department

Craig Dickson, RRT

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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%

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St.Joseph’s PFT

• Referral process• Testing options for COPD• Contraindications• Wait times• Interpretations • ABCs of PFT

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GP-Respirology Referral Form

The cohort will trial this form over the Action Period.

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Smoking CessationDerek Poteryko, M.D.

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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

Session Objectives

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Evaluations

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Questions?