National COPD Audit Programme: Pulmonary Rehabilitation Organisational Audit Dataset 2015 (Part 1)

Transcription

1 1. Patient Intake 1.1 Which self-reported MRC graded patients do you offer PR to? (tick all that apply) Grade 1 MRC dyspnoea grades: 1.t troubled by breathlessness except on strenuous exercise. 2.Short of breath when hurrying or walking up a slight hill. 3.Walks slower than contemporaries on level ground because of breathlessness, or has to stop for breath when walking at own pace. 4.Stops for breath after walking about 100 metres or after a few minutes on level ground. Grade 2 Grade 3 Grade 4 Grade 5 t known/not recorded 5.Too breathless to leave the house or breathless when dressing or undressing. 1.2 Do you exclude patients who are current smokers? ComboList 1.3 Do you offer PR to patients who have completed a programme over a year ago? (tick all that years ago apply) years ago - 5 or more years ago 1.4 Which non-copd conditions would be accepted by your PR programme? (tick all that apply) ne If you accept patients which a primary diagnosis other than COPD please select the applicable conditions. Asthma Bronchiectasis Heart failure Interstitial lung disease Kyphoscoliosis Lung cancer Obstructive sleep apnoea Obesity related breathlessness Primary pulmonary hypertension Sarcoidosis Page 1 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

2 1. Patient Intake 1.5 Do you provide early post discharge PR (within one month of discharge) for patients ComboList - fully met discharged from hospital with a diagnosis of acute exacerbation of COPD (AECOPD)? Fully met means you are able to offer and begin PR within one month of discharge for all eligible patients. Partially met means you aim to provide PR to all eligible patients within one month of - partially met discharge but are not always able to deliver in this time. 1.6 Do you accept referrals for elective PR following discharge from hospital for AECOPD? ComboList Page 2 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

3 2. Structure and Content of Programme 2.1 What types of PR programme do you offer? (tick all that apply) Rolling A rolling programme is a continuing cycle of sessions, with patients joining when there is a space and leaving after completing a programme of sessions. A cohort programme is where all Cohort patients start and finish the programme at the same time. 2.2 Do you offer a group-based and/or one-to-one PR programme? ComboList Group-based One-to-one Both 2.3 Is your PR programme open all year round? ComboList 2.4 How many exercise sessions of PR do you offer per programme? (excluding the assessment visits) An 'exercise session' means a supervised session of pulmonary rehabilitation where exercise is performed or undertaken. 2.5 How frequently do patients usually attend? ComboList 1 session per week 2 sessions per week 3 sessions per week 4 or more sessions per week 2.6 Do you offer an initial assessment before enrolment onto the PR programme? ComboList Please answer if you conduct separate individual patient assessments before the patient joins group exercise sessions. If you assess patients during or as part of group exercise session then please answer. 2.7 Do you offer a discharge assessment? ComboList Please answer 'yes' if you re-assess patients at the end of the programme. This does not need to be during a dedicated assessment appointment but should be done separately from the PR class. Page 3 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

4 2. Structure and Content of Programme 2.8 What modes of exercise training are offered during the rehabilitation? (tick all that apply) Circuit training Cycling Interval training Neuromuscular electrical stimulation (NMES) Strength training using free weights Strength training using multi-gym equipment Walking 2.9 How is aerobic exercise prescribed? (tick all that apply) t done / not applicable Using Borg or perceived exertion scores to assess intensity CPET test to measure peak VO2 ISWT to predict peak VO2 6MWD equation Ad hoc / best guess 2.10 What intensity of aerobic exercise prescription is used? (tick all that apply) <65% Please indicate the intensity at which aerobic exercise is prescribed during pulmonary rehabilitation as a percentage of maximum exercise performance (using whichever test you use in your programme) measured at the initial assessment % 76-85% >85% t done / not applicable 2.11 How is strength training prescribed? (tick all that apply) t done / not applicable 1RM is the maximum weight that can be lifted by the relevant muscle group for a single repetition. Ad hoc / best guess Borg perceived exertion scores 1RM Page 4 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

5 2. Structure and Content of Programme Is home exercise prescribed? ComboList If yes, is the home exercise prescription individually tailored? ComboList 2.13 How is muscle strength measured? (tick all that apply) Isometric 1RM is the maximum weight that can be lifted by the relevant muscle group for a single repetition. 1RM t done / not applicable 2.14 Which measures of aerobic exercise performance do you use at assessment or refer to as t done / not applicable outcome measures? (tick all that apply) Incremental shuttle walk test (ISWT) Endurance shuttle walk test (ESWT) Six minute walk test (6MWT) Cycle or treadmill ergometry Cycle or treadmill endurance test 4 metre gait speed test Cardio pulmonary exercise test (CPET) 2.15 Which measures of health status do you use? (tick all that apply) t done / not applicable St Georges Respiratory Questionnaire (SGRQ not SGRQ-C) Chronic Respiratory Questionnaire (CRQ) COPD Assessment Test (CAT) Page 5 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

6 2. Structure and Content of Programme 2.16 Which measures of dyspnoea do you use? (tick all that apply) t done / not applicable Medical Research Council (MRC) breathlessness scale COPD Assessment Test (CAT) Baseline Dyspnoea Index/Transition Dyspnoea Index (BDI/TDI) 2.17 Do you measure any of the following? (tick all that apply) t done / not applicable Activities of daily living Knowledge gained during education Patient satisfaction Physical activity Psychological status 2.18 Is training progression recorded in a written patient exercise diary? ComboList t known 2.19 Does your programme inform referrers of the outcome of PR for each patient? ComboList - always - mostly - sometimes Never 2.20 Does your programme inform GPs of the outcome of PR for each patient? ComboList - always - mostly - sometimes Never Page 6 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

7 3. Education and Patient Information 3.1 How many hours of education are scheduled during a complete PR programme? Please give the time spent on education during a standard complete programme to the nearest hour. 3.2 How is education provided? (tick all that apply) Face-to-face taught group sessions Written hand-outs DVD given to patients CD given to patients Information on dedicated website t done / not applicable 3.3 If you offer face-to-face group sessions, who delivers these? (tick all that apply) Registered nurse Physiotherapist Occupational therapist Respiratory physician Health psychologist Clinical psychologist Dietician Pharmacist Respiratory physiologist Exercise physiologist Fitness instructor Technical instructor Healthcare/therapy assistant Social worker t done / not applicable Page 7 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

8 3. Education and Patient Information 3.4 Do you send patients written information about your PR programme prior to their initial ComboList appointment? t known 3.5 Do you provide patients with a written discharge exercise plan with maintenance advice? ComboList Occasionally 3.6 If needed, are you able to offer written information in a format that meets the needs of - translated material in any language non-english speaking or partially sighted patients? (tick all that apply) required - translated material in some languages - large print - Braille 3.7 Are interpreters available when required? ComboList - always - mostly - sometimes Never Page 8 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

9 4. Programme Provision 4.1 What type of organisation provides your PR programme? NHS Trust or Health Board Community Interest Company (CIC) Private healthcare provider Charity Research 4.2 From which sources does your PR programme accept referrals? (tick all that apply) GPs Practice nurses Hospital physicians Respiratory nurse specialists Physiotherapists Occupational therapists Respiratory physiologists Community services Home oxygen teams Self-referral 4.3 How is your PR programme funded? (tick all that apply) CCG commissioned Hospital funded Post-discharge rehabilitation tariff Does your PR programme have a fixed term of funding? ComboList t known If yes, how many years' future funding does the programme have? Please round up or down to the nearest whole year. If you have multiple funding sources, please give an average figure. Page 9 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

10 4. Programme Provision 4.5 How many referrals did your PR programme receive in the financial year April March 2014? Tick here if not known Boolean 4.6 How many of the referrals noted at 4.5 were for COPD? Tick here if not known Boolean 4.7 How many initial assessments did your PR programme complete in the financial year April March 2014? 4.8 How many programme spaces (for all sites) did your PR programme offer in the financial ComboList 0-50 year April March 2014? Please give the number offered, not the number actually taken up How many sites does your programme offer PR at? Please note that you will be asked to answer questions on each site in Part 2. Page 10 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

11 5. Staffing 5.1 Please give details of all funded staff at your PR programme as at 1 Jan CaptionText WTE = Whole Time Equivalent and is based on the hours normally worked by a full-time employee. E.g. 1 full-time member of staff is 1 WTE, a person working part-time 3 out of 5 days would be 0.6 WTE. Please only include staff time spent on PR. If an individual contributes very little time, e.g. only occasional education sessions, then please exclude. For the following questions ( ) please include staff who are absent on 1 Jan If you have no staff at a particular band please enter 0. Details of vacant posts should be given at question 5.2. If your organisation does not use the Agenda for Change bandings please still record posts under the equivalent band. Possible alternative job titles are: Admin and clerical: secretary, admin assistant, clerk, support officer; Healthcare support worker: assistant, technician, exercise/fitness instructor; Qualified nurse: specialist nurse, nurse practitioner, consultant nurse; Qualified physiotherapist: highly specialised physiotherapist, consultant physiotherapist, senior physiotherapist; Qualified occupational therapist: clinical specialist occupational therapist How many band 2 WTEs are employed? 5.1.1a Which roles does this include? (tick all that apply) t applicable Admin and clerical Health support worker How many band 3 WTEs are employed? 5.1.2a Which roles does this include? (tick all that apply) t applicable Admin and clerical Healthcare support worker How many band 4 WTEs are employed? Page 11 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

12 5. Staffing 5.1.3a Which roles does this include? (tick all that apply) t applicable Admin and clerical Healthcare support worker How many band 5 WTEs are employed? 5.1.4a Which roles does this include? (tick all that apply) t applicable Admin and clerical Healthcare support worker Qualified nurse Qualified physiotherapist Qualified occupational therapist Dietician How many band 6 WTEs are employed? 5.1.5a Which roles does this include? (tick all that apply) t applicable Qualified nurse Qualified physiotherapist Qualified occupational therapist Dietician Pharmacist How many band 7 WTEs are employed? Page 12 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

13 5. Staffing 5.1.6a Which roles does this include? (tick all that apply) t applicable Qualified nurse Qualified physiotherapist Qualified occupational therapist Dietician Pharmacist How many band 8a WTEs are employed? 5.1.7a Which roles does this include? (tick all that apply) t applicable Qualified nurse Qualified physiotherapist Qualified occupational therapist Dietician Pharmacist How many band 8b WTEs are employed? 5.1.8a Which roles does this include? (tick all that apply) t applicable Qualified nurse Qualified physiotherapist Qualified occupational therapist Dietician Pharmacist 5.2 How many WTE funded posts were vacant as at 1 January 2015? Page 13 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

14 5. Staffing 5.3 What percentage of staff have received annual basic life support training in the past 12 ComboList ne months? 1-25% 26-50% 51-75% 76-90% % 6. Record Keeping 6.1 Do you have a Standard Operating Procedure detailing local policies? ComboList 6.2 If yes, what does the Standard Operating Procedure cover? (tick all that apply) t applicable Accessibility Patient safety Minimum staffing levels Capacity Environment Risk assessments 6.3 Do you keep a local database of programme information? ComboList A database could be an electronic or paper-based records system. 6.4 If yes, what does the database cover (tick all that apply) t applicable Patient details Attendance Treatment Outcomes Completion rates Page 14 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

15 7. Audit Participation 7.1 How many patients were eligible for this audit? I.e. how many patients with a primary respiratory diagnosis of COPD attended an initial assessment/first appointment between 12 January and 10 April 2015? 7.2 How many eligible patients were approached and asked to consent to be included in this audit? 7.3 How many patients gave consent to be included in this audit? Page 15 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

16 National COPD Audit Programme: Pulmonary Rehabilitation Organisational Audit Dataset 2015 (Part 2) 1. Site Specific Questions 1.1 What type of venue is this site? Acute hospital Community hospital GP surgery Health centre Local leisure centre or gym Church or community hall Prison 1.2 What is the maximum group size? 1.3 What is the minimum number of staff for a maximum sized group? 1.4 Do you have access to on call on site emergency medical assistance during PR classes? - available on site - available over telephone 1.5 Do you have access to emergency resuscitation equipment at this site? ComboList 1.6 Is funded transport offered to enable patients to attend PR at this site? ComboList - to all who require it - to those who fit local transport provision criteria - but we provide information on voluntary services 1.7 What parking facilities are available at this site? ComboList Free parking Paid parking ne Page 1 of Healthcare Quality Improvement Partnership Ltd. (HQIP).

17 National COPD Audit Programme: Pulmonary Rehabilitation Organisational Audit Dataset 2015 (Part 2) 1. Site Specific Questions 1.8 Are patients at this site routinely formally referred to follow up services? ComboList - in-house follow-on services Please select the appropriate option if you normally refer patients to any follow-on services, whether these are standardised or individually tailored services. - external follow-on services - in-house and external follow-on services t known Page 2 of Healthcare Quality Improvement Partnership Ltd. (HQIP).