By Denise Williams | News & Views
Anybody who works in pulmonary rehabilitation (PR) understands the ideal sequence of events: patient is admitted to the hospital for COPD exacerbation; patient is referred to and enrolled in PR; patient adheres to the regimen and benefits from it; and, subsequently, patient avoids the need to be readmitted.
Anybody who works in PR also is familiar with the alternate reality: despite a plethora of patients with a COPD diagnosis, many are not referred to PR and those who do enroll often fail to stick with it due to any number of barriers. As a result, too many of these patients end up back where they started – potentially in worse shape medically than before – in a cycle that weighs down the healthcare system in terms of time, space and dollars.
Changing for the Better
Value-based care (VBC) turnkeys hold the promise of more efficient delivery of care and a more satisfactory experience for patients and providers alike. “Programs often keep doing the same thing over and over because it’s what they’ve always done,” explains Karen A. Edwards, MS, RCEP, RRT, FAACVPR, who chairs AACVPR’s Value-Based Care Committee. “The goal with the turnkeys is to take a different look and see if [the usual way] is really working.”
So-called change packages were rolled out to introduce VBC best practices for cardiac rehab and smoking cessation in 2018 and 2019, respectively, in partnership with CDC and Million Hearts. However, the VBC panel recognized an unmet need for a similar plan-do-study-act protocol for PR. “That’s where the turnkeys come in,” says Edwards.
She and other committee members have been working for the last year and a half to introduce pulmonary-specific guidance to the turnkey menu. The third of three PR sections has finally been uploaded to the AACVPR website, where they can be accessed under the “Admin” heading.
Ask the Experts
Panel members are eager to hear the PR community’s feedback and field any questions about the turnkeys. To this end, AACVPR hosted a live webcast on May 3 to highlight the new resources. During the hour-long event, Richard Sukeena, MS, MBA, FAACVPR, discussed the turnkey developed for referral and enrollment. Edwards addressed the turnkey specifically focused on adherence, while Tracy A. Herrewig, MS, RCEP, MAACVPR, showcased the turnkey targeted at reducing hospital readmissions. Collectively, the three segments deliver an awareness of what kinds of data viewers should be gathering and what strategies they can pursue to enhance their performance in the areas discussed.
Edwards expects the new turnkeys to spawn plenty of questions. She already knows one that might come up: Are the turnkeys intended exclusively for COPD? The answer, she says, is a resounding “no!” Although the document language is framed around this common condition, owing to the wealth of pertinent data and research, Edwards emphasizes the turnkey scope reaches far beyond that. “The information is applicable to other pulmonary populations,” she assures.