Timing Is Everything

Abstract

Background:

Pulmonary rehabilitation is typically done on patients with stable lung diseases like COPD, but research is now supporting that pulmonary rehabilitation is beneficial for patient's days after an acute exacerbation of COPD. The purpose of this research was to investigate pulmonary rehabilitation patient charts to see if there is a lag time between order dates and the dates that patients start pulmonary rehabilitation.

Methods:

The research design used to complete this project was by collecting historical data by chart review. The information that was collected were ages, sex, insurance company, order date for pulmonary rehabilitation, date starting pulmonary rehabilitation, how many sessions they attended pulmonary rehabilitation, patient's insurance companies and how many visits the insurance would allow for pulmonary rehabilitation, how many days/weeks between order date and start of rehabilitation, and hospital admissions after pulmonary rehabilitation if applicable. Permission was granted by the University Institutional Review Board (IRB), as well as the hospital prior to data collection.

Results:

Fifty patient charts were reviewed, the average timeline between the dates that the pulmonary rehabilitation was ordered till the time that the patient started rehabilitation was 6.6 weeks. This result shows that there are some large waiting period patients are waiting to start treatment. The least amount of time that a patient waited was 2 weeks and the longest amount of time that an individual waited to start rehabilitation from the time it was ordered was 31 weeks. Seven of the 50 patients never started pulmonary rehabilitation. Insured patients on average waited 4 weeks between the order dates till the start of pulmonary rehabilitation, while patients that were uninsured/self-paid waited 4.5 weeks on average. Of the 50 patient's charts that were reviewed, 6 of them had been readmitted to the hospital for an exacerbation of COPD while waiting to start pulmonary rehabilitation.

Conclusions:

The limitations in this study was the inability to know why there is the long period of time between patients receiving the order to be treated at a pulmonary rehabilitation facility and the time they start. Finding the reason or reasons for this prolonged time will only help health care professionals to help patients faster and give them the confidence they need to manage their disease and reduce the amount of readmission to the hospital.