An IMP to "take care" of COPD!

Francisco Santos Coelho, Patrícia Tuna, Catarina Rego Carvalho, Tiago Pinto Neto, Bárbara Reis, Anabela Pereira

Keywords: COPD; Chronic Obstructive Pulmonary Disease; Internal Monitoring Plan; Continuous Improvement; Primary Healthcare

Background:

Chronic Obstructive Pulmonary Disease (COPD) is a disease with high morbidity and mortality. Its prevalence in Portugal is around 14% in individuals over 40 years old. An Internal Monitoring Plan (IMP) was developed in order to improve the approach to patients with COPD.

Research questions:

Evaluate and ensure the quality of care for patients with COPD, adopting corrective measures to improve the services provided.
Achieving and maintaining a Global Quality Standard (GQS) of at least 80% in all evaluated criteria.

Method:

Observational study (2019-2022). All patients diagnosed with COPD at USF Valongo (USFV) until 2022 were eligible. Ten of these patients were randomly selected from each physician’s list. 16 indicators were evaluated through regular audits. Thereafter, they were discussed and corrective measures were applied. The GQS was calculated at the end of each evaluation and compared with the previous years. The data were analyzed using Excel®.

Results:

The prevalence of COPD in USFV is 1.12%. In the last evaluation (1stSemester2022), all 16 indicators achieved a Fulfillment Index ≥ 80%, which corresponded to a GQS=100%. This value symbolized an increase of 75 percentage points relative to the first assessment (1stSemester2019) and 60 percentage points relative to the Annual2021.

Conclusions:

COPD has a high impact on patient’s quality of life.
Projects like this are essential to improve the quality of healthcare, highlighting the role of the joint work of healthcare teams. A major improvement in our results was obtained, with the fulfillment of all the analyzed indicators. This was owing to a concerted effort by the team, especially in a post-pandemic context - reason of great satisfaction.
However, the prevalence of COPD in USFV is clearly below the Portuguese national level, which may be due to underdiagnosis/undercoding. Therefore, it is essential to increase the index of suspicion for the disease and to be proactive in its diagnosis.

Points for discussion:

Relevance of IMPs on Continuos Improvement of healthcare teams.

Impact and relevance of COPD on Primary Care.

The role of the joint work of healthcare teams.