Study Finds 1 Additional Staff Meeting Can Reduce Length of Hospital Stays in Patients With COPD By 67%

According to study findings published in The Journal of the American Osteopathic Association, the implementation of integrated care conferences (ICCs) by provider teams can significantly reduce the length of hospital stays in patients with chronic obstructive pulmonary disease (COPD) by up to 67%.

ICCs are daily meetings held by provider teams and typically led by nursing supervisors, addressing topics relating to the patients’ progress and delineating the necessary steps to getting each patient healthy enough to discharge. In commentating on his first experience observing ICCs, lead study author Ryan Shilian, DO, adult and pediatric allergy/immunology fellow with University Hospitals Cleveland Medical Center, detailed how he was “awestruck by how much easier and efficiently everything ran.”

However, most hospitals instead employ other techniques to examine patients’ progress, such as multidisciplinary rounds (MDRs) in which the attending physician visits each patient with other residents, medical students, nurses, ancillary clinicians, and staff to discuss the diagnoses and plans for treatment. Because MDRs are often held at the bedside, Shilian stresses that there is little space and time for the large group to have a meaningful discussion and/or input on patient care.

“At the vast majority of hospitals, it is left up to the primary physician to physically seek out and coordinate supporting services,” said Shilian. This lack of a set communication outlet can contribute to inefficiencies in care coordination, especially when it comes to deciding whether a patient is healthy enough for discharge. Among patients with COPD, a longer length of stay for exacerbation hospitalizations was associated with higher risk for readmission, indicating the significant risk posed toward this population.

Researchers sought to examine the impact of ICCs on care coordination by analyzing 2 osteopathic community hospitals in Ohio; one hospital used daily ICCs and the other hospital did not. The retrospective study included an analysis of the average length of stay for participants with COPD exacerbation (n = 1683) at each hospital, who were selected using electronic health records.

In the study findings, the hospital using daily ICCs exhibited a shorter mean (SD) length of stay of 3.37 (2.89) days, compared with 5.55 (3.99) days in the hospital without daily ICCs (P <.0001). When compared with patients at the hospital without daily ICCs, participants at the hospital with daily ICCs exhibited significantly shorter length of stays based on age groups of 40 to 69 years (67%) and 70 to 99 years or older (36%).

“Implementing daily ICCs may make current health care services and coordinated care more efficient, resulting in decreased costs and length of stay for patients with COPD exacerbation,” said the study authors.

Reference

Shilian R, Abraham T, Wynbrandt J. Daily integrated care conferences to reduce length of hospital stay for patients with chronic obstructive pulmonary disease. J Am Osteopath Assoc. 2020;120(3):144-152.