UTILITY OF POWER PLAN IN STANDARDIZING CARE OF HOSPITALIZED COPD PATIENT

Dr. Rumman A. Langah, MD, FACP, FHM*, Emory University Hospital, Atlanta, GA and Rashmi Sharma, M.D, Emory University Hopsital, Atlanta, GA

Meeting: Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev.

Abstract number: 183

Categories: Quality Improvement, Research Abstracts

Keywords: ,

Background: Several studies attest the effectiveness of physician order set, also known as Power Plan (PP) in standardizing patient care and improving outcomes. In general, PP use is suboptimal. We hypothesized that PP use in patients admitted with Chronic Obstructive Pulmonary Disease (COPD) assists in  standardization and appropriateness of inpatient management.

Methods: We conducted a retrospective chart review of 60 patient encounters admitted with primary diagnosis of COPD exacerbation to a university hospital over a 2-month period. With the help of data warehouse personnel, we selected consecutive 30 patients from each group: (a) encounters with PP use (called PP+); (b) encounters without PP use (called PP-). 9 patients were excluded due to incorrect diagnosis or incomplete information. Various management metrics were compared between the two groups (n=26 and 25 respectively)

Results:

Table shows that the proportion of patients receiving 1) arterial blood gas (ABG) within 12 hours of arrival, 2) standard steroid dose and 3) appropriate antibiotic therapy were superior in PP+ group compared to PP- group. Importantly, though Bundle management (all three criteria) use was overall low but twice as high in PP+ group compared to PP- group.

Table 1: Comparison of treatment metrics

  PP+ (%)

(n = 26)

PP- (%)

 (n = 25)

ABG within 12 hours of arrival 17 (66%) 11 (40%)
Steroid use 25 (96%) 24 (96%)
Standard steroid dose ∏ 17 (65%) 12 (48%)
Antibiotic use 22 (85%) 22 (88%)
Appropriate antibiotic choice † 23 (88%) 18 (72%)
Nebulized B-agonist 23 (88%) 21 (84%)
Bundle management * 7 (27%) 3 (12%)

∏ As per GOLD guidelines/REDUCE trial: Prednisone 40 mg daily

† One of the following per GOLD guidelines: doxycycline, aminopenicillin, azithromycin or levofloxacin

* As described above in Results section

Conclusions:

COPD power plan use resulted in greater adherence to several management metrics in accordance with guidelines and institutional recommendations, along with superior standardization.

To cite this abstract:

Langah, RA; Sharma, R . UTILITY OF POWER PLAN IN STANDARDIZING CARE OF HOSPITALIZED COPD PATIENT. Abstract published at Hospital Medicine 2017, May 1-4, 2017; Las Vegas, Nev. Abstract 183. Journal of Hospital Medicine. 2017; 12 (suppl 2). https://www.shmabstracts.com/abstract/utility-of-power-plan-in-standardizing-care-of-hospitalized-copd-patient/. Accessed July 16, 2019.

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