This document summarizes the progress and next steps of a 90-day plan to improve COPD patient care and inhaler technique training. It notes that: - Baseline data has been collected on current patients receiving inhaler reviews. - Additional training is needed, as the number of staff competent to provide technique reviews is currently low. Training dates for inhaler technique reviews have been set for January 2020. - A process to identify COPD patients across organizations has been developed, with daily patient listings. - Monitoring of inhaler technique reviews will continue with sustained focus on respiratory wards to ensure all COPD patients receive a review. - Reflections on the process note it requires input from

1. North West COPD Joint
Collaborative
Thursday 5th December 2pm
WEBEX

2. 1. Our high impact actions 2. One action that we commit to delivering or testing in the next 90 days:
3. Why is it important? 4. Changes required to help achieve the
action in 90 days
5. Who’s involved and who could be involved: 6.How do we know we’ve made a difference? (measures)
Actions in next 30 days: Actions in next 60 days: Actions in next 90 days: Help required:
ROYAL HEALTH HOSPITAL
Additional training as
required X
Devise process for
patient identification
and review √
Aim Increase the no. of patients having their inhaler technique checked from 30% to 60% by March 2020.
Data – patient review
Education – inhaler
technique review
Monitoring - measures
to assess improvement
Correct technique improves
patients’ ability to self-manage
May prevent admissions for acute
exacerbations and reduce
emergency medication use
Respiratory team: specialist nurses, doctors,
pharmacists, HCAs, physiotherapists; BI team
Review baseline data
on patients receiving
review - √
Identification of team
members able to
review technique √
Test process on
sample of wards
initially
Measure, review and
roll out
Commitment from
senior staff to support
resource use
Information for patients
on why this is necessary
List of patients admitted with COPD
exacerbation obtained each day
Training additional staff to review
Number of patients with completed inhaler
technique review recorded in bundle
documentation/notes; could measure by ward
Assign dedicated team members to review patients’ technique

3. Summary
69 days into 30/60/90 Plan
• Baseline data collected on patients currently receiving review –
higher numbers of patients receiving review on resp ward
• Review of numbers of team competent to deliver inhaler
technique training - numbers low and spread across primary & secondary care
• Identified need for additional trainers to deliver training to ward
based staff on inhaler technique- volunteers requested from varied
disciplines from each division
• Training dates set – Jan 2020
• Ongoing monitoring of inhaler technique for all COPD with
sustained focus on respiratory wards ….for all to have review
• Process to identify COPD patients across organisation devised –
BI input – listing daily

4. REFLECTIONS
On process/ learning /implementing improvement /change
PEOPLE
• Requires input from across the MDT
• Improved communication internally
and with partners to ensure
streamlined patient pathway
• Staff capacity to develop project -
limited
PROCESS
• Continuous improvement across
pathway
• Lots of disciplines involved
• Differing requirements for patients
with COPD
ORGANISATION
• Leadership necessary
• Support from CCG – commissioning
of pathway
• Admission/ discharge processes vary
LEARNING
• No quick fix
• Processes require regular review
• Process mapping of patient journey
support improvement
• Start small!

5. Additional Support
What support/ help to ensure aim achieved?
• Resource to deliver inhaler technique training
• Suggestions on data collection to ensure all relevant
patients receive review
• How to collate information for patients who leave
hospital without review and then have in community
• Insight into the allowable answers for NACAP –
inhaler technique