Introduction and Objectives A secure discharge from hospital following an admission for COPD is an important reflection of the quality of hospital care. Information about the discharge process will help inform strategies to prevent unnecessary re-admissions.
Methods An 8-item questionnaire was sent to respiratory departments in all acute hospitals in the United Kingdom. Recipients were asked about their hospital's processes and the provision of information to patients at discharge.
Results 68 hospitals returned the questionnaire. There was coverage of hospitals from all regions of England as well as Scotland and Wales. The majority (69%) of responses came from district general hospitals (DGHs). Catchment populations ranged from 100 000–1 million. Respiratory departments varied in size from <20 beds (10.3%) to >60 beds (11.8%). Almost half the departments (48.6%) have >70 COPD admissions per month. There was an early discharge service in many hospitals (71%), with most being based in the hospital (67%) vs the community. Only 52.9% patients were seen by a respiratory physician before discharge; the majority (69.1%) were seen by a specialist nurse. Most hospitals (52.9%) did not have a formal discharge check list or discharge pack (63.2%). Many hospitals (69%) give patients a copy of the discharge letter, and some refer patients directly to pulmonary rehabilitation (54%) or smoking cessation services (63%) on discharge. Follow-up appointments within primary or secondary care were not universally arranged and there was patchy coverage of educational advice to patients (range: 45%–75%), especially on return to work or sexual relationships.
Conclusions Whilst admissions for exacerbations of COPD are common, preparation for discharge is unsatisfactory. Many patients do not see a specialist or have appropriate post-discharge advice or follow-up arrangements.
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Funding The survey was supported by an educational grant from Nycomed.
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