DETRIMENTS TO PULMONARY REHABILITATION REFERRAL IN A RURAL COMMUNITY HOSPITAL: THE QI PROJECT

ABSTRACT

SESSION TITLE Respiratory Care Oxygen, Rehabilitation, and Inhalers SESSION TYPE Original Investigation Posters PRESENTED ON 10/18/2022 0130 pm - 0230 pm PURPOSE: 1.To educate patients about the severity of their disease process while inpatient. 2.To educate about and offer Pulmonary rehabilitation before they are discharged from the hospital. METHODS: 1.Education of care team regarding importance of pulmonary rehabilitation. 2.Forming a report in EPIC (EMR) enlisting current COPD exacerbation inpatients. 3.Approaching patients in a multidisciplinary fashion regarding pulmonary rehabilitation. RESULTS: There was an average of 3-5 inpatient COPD exacerbation patients per week who were approached from the begining of our QI. We saw less than 5% of patients actually enrolling and coming through pulmonary rehabilitation. CONCLUSIONS: In a rural setting there are a lot of factors that play a role in healthcare disparities. Taking an example of COPD patients in our community, despite having a functional pulmonary rehabilitation program and innovative approach to education and enrollment regarding pulmonary rehabilitation, we still faced a lot of obstacles in having the COPD patients to be able to follow and get help through outpatient pulmonary rehabilitation. The main reasons stated are as follows - lack of transportation, high fall risk, no insurance/inability to afford pulmonary rehabilitation, baseline poor functional status. CLINICAL IMPLICATIONS Despite numerous benefits, traditional Pulmonary Rehabilitation (PR) as a resource remains underutilized in chronic lung disease.Less than 3% of eligible candidates for PR attend one or more sessions after hospitalization due to many barriers, including the ongoing COVID-19 pandemic. Our QI project is an effort to educate COPD patients on the importance of pulmonary rehabilitation while they are admitted inpatient for an exacerbation. Going through the project, we identified several valid reasons on why Pulmonary rehabilitation still remains an underutilized tool in this disease. We hope to establish reasons and work on approaching different hurdles that are faced. Accessibility in terms of higher number of rehabilitation programs and functional transport to and from, better insurance coverage on the part of insurance companies, better understanding of the disease process and patient education are all the different factors that can be worked on. DISCLOSURES No relevant relationships by Parul Dutta No relevant relationships by Gaurav Dutta