Hospitals pilot lung disease project

COPD program reduces ER visits

Two area hospitals have dramatically reduced emergency room visits for a chronic disease that is becoming a strain on the health-care system.

Hamilton Health Sciences and Burlington’s Joseph Brant Hospital are among 19 Canadian health-care teams working to reduce hospitalizations for chronic obstructive pulmonary disease (COPD) as part of a pilot project with impressive early results.

It’s significant considering the progressive and debilitating lung disease now causes more hospitalizations in Canada than any other chronic illness.

“It’s a tremendous driver of healthcare costs,” said Stephen Samis, vicepresident of programs at the Canadian Foundation for Healthcare Improvement which funded the pilot studies.

“COPD is one of the leading drivers of emergency department visits, hos-

pitalizations and readmissions as well as long lengths of stay once in the hospitals. It’s really expensive to treat in acute care.”

HHS was able to reduce emergency room visits by 76 per cent and hospitalizations by 69 per cent for 31 patients enrolled in the INSPIRED program since February 2015. An additional 41 patients are taking part at Joseph Brant. Nationwide about 1,600 patients are in the program.

“The frequent trips back to the hospital are not good quality care for the patient,” said Kelly O’Halloran, director of community and population services at HHS. “There has been a significant improvement in COPD care in Hamilton. It’s breaking down the barriers.”

The INSPIRED program — developed in Halifax — is similar to a new way of treating patients created by Hamilton’s St. Joseph’s Healthcare called integrated comprehensive care.

The patient gets education on how to manage the disease, a team that works together from different sectors of the health-care system, support at home and a number to call when help is needed.

“I listened and I followed everything I could,” said Burlington patient Dave Langdon who said the INSPIRED program helped “tremendously.”

About 800,000 Canadians live with COPD. The numbers are predicted to rise as one in four Canadians over the age of 35 is expected to develop the disease in their lifetime.

Those with advanced cases of the disease are among the highest users of hospital resources which is why the non-profit foundation funded by Health Canada teamed up with pharmaceutical company Boehringer Ingelheim Canada Inc. to provide $2 million to pilot INSPIRED across Canada.

Samis estimates every $1 spent on INSPIRED saved the health care system $21.

“This is doable,” said Samis. “It’s really where we have to go as a country. We can’t continue to rely on hospitals to provide all this care. We have to … shift our focus to the community and build up our capacity to help people self-manage. Let’s use hospital-based care for when we really need it.”

The program, which is expected to expand to patients with congestive heart failure, is about more than just saving dollars. It also helps patients manage a poorly understood and scary disease characterized by breathlessness.

“Some of the patients are saying this approach to care is giving them their lives back,” said Samis. “They are able to walk up a flight of stairs, get to their son or daughter’s wedding and some have actually gone back to work. There has been a tremendous increase in the ability of people to exercise, travel and return to daily activities the rest of us take for granted.”

INSPIRED stands for Implementing a Novel and Supportive Program of Individualized care for patients and families living with REspiratory Disease.

We have to … shift our focus to the community and build up our capacity to help people self-manage. STEPHEN SAMIS