Effects of Pneumonia Education on Hospital Readmission for COPD Patients

Abstract

Background:

Pneumonia and COPD are two diagnoses that carry a 30-day hospital readmission penalty implemented by the Centers for Medicare and Medicaid Services in 2012. Based on two 2018 studies, COPD patients are not knowledgeable on the signs and symptoms of pneumonia. COPD patients are also more likely to develop pneumonia. The purpose of this study was to evaluate the outcomes of a patient education program for the reduction of early hospital re-admission for these two diagnoses.

Methods:

Using the same survey items from two 2018 studies, an educational brochure Pneumonia and You” was developed for patients enrolled in this study. The brochure identifies seven major symptoms of pneumonia: fever, cough, chest pain, mucus production, shortness of breath, fatigue, and nausea/vomiting/diarrhea. Institutional and hospital IRB approvals were obtained. In-patients with COPD were recruited from a private hospital in Alabama. Verbal and written consents were obtained. Following patient education on the signs and symptoms of pneumonia, the brochure and a reminder key chain were given to the patient. Each patient was contacted by phone 5 weeks following initial patient contact. Patient admission records were also reviewed to cross-check the readmission information, if any. Data was reviewed and summarized by a descriptive method.

Results:

All 10 enrolled patients had a diagnosis of COPD plus one of these conditions: pneumonia, CHF, chest pain, STEMI, head injury, general weakness, and atrial fibrillation. Six answered the phone when called five weeks after initial contact. Readmission information for all 10 patients were cross-checked using the EMR. Of the 10 enrolled COPD patients, only 2 were readmitted within 30 days of discharge from hospital, one for chest pain and the other for CHF. One patient had not left the hospital during the time period of study. Two patients were admitted to nursing homes upon discharge from the hospital. The remaining 5 patients were discharged home and were not readmitted to any acute care facility. In summary, of the 9 discharged COPD patients, none of them were readmitted for COPD or pneumonia.

Conclusions:

The patient educational program (in-person visit, brochure, and reminder key chain) appears to be an effective tool to prevent hospital readmission within 30 days. Due to time constrains, the limitations of this study include low number of enrolled COPD patients and short duration of data collection (5 weeks). "