Rushcliffe Cardiorespiratory team highlighted as example of best practice
We are delighted that the Rushcliffe Cardiorespiratory team at Nottinghamshire Healthcare has been highlighted as an example of best practice for 100% of patients with stable Chronic Obstructive Pulmonary Disease (COPD), starting Pulmonary Rehabilitation (PR) within 90 days of referral.
The National Respiratory Audit Programme (NRAP) collated a series of case studies which highlight good practice in patient care for pulmonary rehabilitation (PR).
Pulmonary rehabilitation is an evidence-based six-week programme of exercise and education. The aim of pulmonary rehabilitation is to; reduce breathlessness when carrying out day-to-day activities, improve physical fitness and strength, improve quality of life, improve energy levels and improve knowledge and understanding of the patients’ lung condition.
Before a quality improvement (QI) project began the team had 60% of patients starting their PR within 90 days of referral. For 2023/24 to see this go up to 100% is fantastic.
The QI project supported by the RCP Royal college of Physicians, began at the end of 2021 and into 2022 and really helped the team understand their bottlenecks in delivery of PR to patients, and helped them to make changes to ensure processes are more streamlined, as far as they are able within service constraints.
One of the main projects to impact access to PR was the introduction of a re-referral route for patients if their journey was suspended at any point. Patients require an initial referral into the Pulmonary Rehabilitation service by a health care professional. If an issue is identified that delays the commencement of PR then if appropriate, the patient is discharged with an open appointment, allowing the patient to contact the team within a three-month window and their referral is re-instated. This has gained positive benefits in managing the PR wait list. A patient referral may previously have remained open on the wait list during any delays.
The team have received excellent feedback from patients about the PR groups. One patient commented:
“Charlotte and Karen are our groups nurses, wow what a difference they have made to my life! In the first couple of weeks I found it quite difficult to do all the exercises, after the first week I just wanted to sleep! I have felt the difference a little more after each session, I can now walk for 6-7 minutes at pace ,and really enjoy it. I'm no longer scared of getting out of breath as I have learned how to breathe properly, how to empty my lungs as well as fill them, something I definitely didn't know before. I lift weights with my legs, I started at 1kg and have now moved up to 3kg! I can use the arm weights better now and have progressed from 1kg to 3kg, I have so much more energy.
“But more than the physical improvements, Charlotte and Karen have given me so much information about living with my disability, they have given me back my confidence and self belief, for which I will be forever grateful, what an amazing group I have been a part of, different people coming together for the same reason, to learn how to adjust and manage an illness that none of us could foresee.”
