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Improving outcomes for people with COPD by developing networks of general practices: evaluation of a quality improvement project in east London.

Hull S, Mathur R, Lloyd-Owen S, Round T, Robson J - NPJ Prim Care Respir Med (2014)

Bottom Line: Between 2010 and 2013 completed care plans increased from 53 to 86.5%, pulmonary rehabilitation referrals rose from 45 to 70% and rates of flu immunisation from 81 to 83%, exceeding London and England figures.Hospital admissions decreased in Tower Hamlets from a historic high base.Key behaviour change included the following: collaborative working between practices driven by high-quality information to support performance review; shared financial incentives; and engagement between primary and secondary care clinicians.

View Article: PubMed Central - PubMed

Affiliation: Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK.

ABSTRACT

Background: Structured care for people with chronic obstructive pulmonary disease (COPD) can improve outcomes. Delivering care in a deprived ethnically diverse area can prove challenging.

Aims: Evaluation of a system change to enhance COPD care delivery in a primary care setting between 2010 and 2013 using observational data.

Methods: All 36 practices in one inner London primary care trust were grouped geographically into eight networks of 4-5 practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary group, including a respiratory specialist and the community respiratory team, developed a 'care package' for COPD management, with financial incentives based on network achievements of clinical targets and supported case management and education. Monthly electronic dashboards enabled networks to track and improve performance.

Results: The size of network COPD registers increased by 10% in the first year. Between 2010 and 2013 completed care plans increased from 53 to 86.5%, pulmonary rehabilitation referrals rose from 45 to 70% and rates of flu immunisation from 81 to 83%, exceeding London and England figures. Hospital admissions decreased in Tower Hamlets from a historic high base.

Conclusions: Investment of financial, organisational and educational resource into general practice networks was associated with clinically important improvements in COPD care in socially deprived, ethnically diverse communities. Key behaviour change included the following: collaborative working between practices driven by high-quality information to support performance review; shared financial incentives; and engagement between primary and secondary care clinicians.

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Related in: MedlinePlus

Chronic obstructive pulmonary disease (COPD) patients with a completed annual review. Tower Hamlets compared with England (95% confidence intervals). Data are from Quality and Outcomes Framework with no exception reporting (http://www.gpcontract.co.uk). This indicator was introduced in 2010.
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fig3: Chronic obstructive pulmonary disease (COPD) patients with a completed annual review. Tower Hamlets compared with England (95% confidence intervals). Data are from Quality and Outcomes Framework with no exception reporting (http://www.gpcontract.co.uk). This indicator was introduced in 2010.

Mentions: Figure 3 compares the annual QOF figures for Tower Hamlets with those for England for this metric. This shows sustained improvement between 2011 and 2013, the higher rates in Tower Hamlets being significantly different from England rates.


Improving outcomes for people with COPD by developing networks of general practices: evaluation of a quality improvement project in east London.

Hull S, Mathur R, Lloyd-Owen S, Round T, Robson J - NPJ Prim Care Respir Med (2014)

Chronic obstructive pulmonary disease (COPD) patients with a completed annual review. Tower Hamlets compared with England (95% confidence intervals). Data are from Quality and Outcomes Framework with no exception reporting (http://www.gpcontract.co.uk). This indicator was introduced in 2010.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373497&req=5

fig3: Chronic obstructive pulmonary disease (COPD) patients with a completed annual review. Tower Hamlets compared with England (95% confidence intervals). Data are from Quality and Outcomes Framework with no exception reporting (http://www.gpcontract.co.uk). This indicator was introduced in 2010.
Mentions: Figure 3 compares the annual QOF figures for Tower Hamlets with those for England for this metric. This shows sustained improvement between 2011 and 2013, the higher rates in Tower Hamlets being significantly different from England rates.

Bottom Line: Between 2010 and 2013 completed care plans increased from 53 to 86.5%, pulmonary rehabilitation referrals rose from 45 to 70% and rates of flu immunisation from 81 to 83%, exceeding London and England figures.Hospital admissions decreased in Tower Hamlets from a historic high base.Key behaviour change included the following: collaborative working between practices driven by high-quality information to support performance review; shared financial incentives; and engagement between primary and secondary care clinicians.

View Article: PubMed Central - PubMed

Affiliation: Centre for Primary Care and Public Health, Queen Mary, University of London, London, UK.

ABSTRACT

Background: Structured care for people with chronic obstructive pulmonary disease (COPD) can improve outcomes. Delivering care in a deprived ethnically diverse area can prove challenging.

Aims: Evaluation of a system change to enhance COPD care delivery in a primary care setting between 2010 and 2013 using observational data.

Methods: All 36 practices in one inner London primary care trust were grouped geographically into eight networks of 4-5 practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary group, including a respiratory specialist and the community respiratory team, developed a 'care package' for COPD management, with financial incentives based on network achievements of clinical targets and supported case management and education. Monthly electronic dashboards enabled networks to track and improve performance.

Results: The size of network COPD registers increased by 10% in the first year. Between 2010 and 2013 completed care plans increased from 53 to 86.5%, pulmonary rehabilitation referrals rose from 45 to 70% and rates of flu immunisation from 81 to 83%, exceeding London and England figures. Hospital admissions decreased in Tower Hamlets from a historic high base.

Conclusions: Investment of financial, organisational and educational resource into general practice networks was associated with clinically important improvements in COPD care in socially deprived, ethnically diverse communities. Key behaviour change included the following: collaborative working between practices driven by high-quality information to support performance review; shared financial incentives; and engagement between primary and secondary care clinicians.

Show MeSH
Related in: MedlinePlus