| Title: | Acute Respiratory Assessment Unit : A Novel Quality Improvement Initiative |
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| Author(s): | T Byrne Dr A Granitsas Dr H McLoughlin |
| Institution: | Portiuncula Hospital |
| Poster: | Click to view poster |
| Category: | General Respiratory and Sleep |
| Abstract: | Background Burden of respiratory disease is challenging. Only 1/3 to 1/2 of individuals with airflow obstruction have a formal diagnosis1 Often respiratory diseases are managed in primary care, without access to diagnostics. Early diagnosis and pharmacological intervention are essential in achieving better clinical outcomes for patients. Methods We piloted the introduction of a Respiratory Assessment Unit (RAU) within the medical assessment unit. The unit facilitated early review of patients with suspected and complex respiratory disease. The RANP facilitated a full clinical examination with access to diagnostics required. Patients received an accurate diagnosis, education, health promotion and commenced on appropriate medication. Results 46.5% (n= 20) were diagnosed with COPD 14 % (n=6) were diagnosed with Asthma. 39.5% (n=17) were referred with other respiratory concerns such as; • Lung Nodules: In high risk patients • OSA: Patients with recent cardiac event/ TIA • Cough: Undetermined origin • Haemoptysis: Un resolving 11% (n=5) required admission 88% (n=38) were discharged Conclusions This pilot in a level 3 hospital corroborated that an RAU provides; • Early accurate diagnosis • Improved patient experience • Reduced Consultant waiting list time • Potential to reduce ED presentations and/or Hospital Admissions A fully resourced RAU within an MAU could provide complex disease management and aid in hospital admission avoidance. Comprehensive local respiratory service should include; Inpatient Review • OPD • RAU • Integrated Care With increasing complexity we estimate that the admission rate would be 25% in keeping with the Acute Medicine Programme KPI. Future Recommendations A permanent RAU would; • Improve patient experience • Reduced waiting lists. • Reduce ED presentations/Hospital Admissions |
