IMPROVING HOME OXYGEN REASSESSMENT AFTER A HOSPITAL STAY

ABSTRACT

SESSION TITLE Respiratory Care Oxygen, Rehabilitation, and Inhalers SESSION TYPE Original Investigation Posters PRESENTED ON 10/18/2022 0130 pm - 0230 pm PURPOSE: Background More than 1.5 million Americans live with supplemental oxygen that improves quality of life in adults living with chronic lung disease. After hospitalization for serious illness such as pneumonia (especially COVID), heart failure, COPD exacerbation or other lung disease, patients are discharged on supplemental oxygen. Hypoxemia often resolves after recovery from the illness and supplemental oxygen is no longer needed. As a part of “Choosing Wisely” campaign from ABIM, ATS/ACCP recommends “For patients recently discharged on supplemental home oxygen following hospitalization for an acute illness, don’t renew the prescription without assessing the patient for ongoing hypoxemia within 90 days after discharge. Objectives The primary objective of the study is to improve home oxygen reassessment after discharge from the hospital. METHODS: Study Design Subjects will be identified by electronic medical records (EMR) report and will include data from the 1st of January 2021 to 30th June 2021 (period of 6 months) Inclusion Criteria Subjects 18 years and older who were discharged from the RPH on supplemental oxygen Exclusion Subjects 18 years and older on oxygen for palliation and hospice Study Outcomes The primary outcome measure will be assessed as percent of patients in whom oxygen requirement reassessed and percent in whom oxygen requirement was not reassessed. The secondary outcome measure will be assessed as percent of patients who had PCP follow up and percent of patients on continuous oxygen without reassessment Quality improvement PDSA Phase I pre-intervention data Phase II Intervention-> education session to the providers and new epic order inclusion (BPA for reassessment and discontinuation) Phase III post-intervention survey RESULTS: Based on chart review, 155 patients qualified for the study criteria. Among 155 patients, regarding the primary outcome-> 63 patients (40.6%) 90 days oxygen reassessment was done, 64 patients (41.2%) oxygen reassessment was not done, 10 patients (6%) died within the 90 days reassessment period and 19 patients were 90 days reassessment was not applicable (12%- 19 patients-on long term oxygen). Regarding the secondary outcomes, 113 patients (72.9%) were followed up with PCP, 16 patients (10.3%) did not have follow up, 19 patients (12.2%- no information available) had outside PCP follow up, 7 patients (4.5%- 2 died on same admission, 5 opted for hospice). Regarding patient who continued to use oxygen, 74 patients (47.7%) were continued on oxygen, 47 patients (30.3%) were discontinued of oxygen and 34 patients (22%) did not have any information available regarding oxygen use. CONCLUSIONS: From the above data, There is room for improvement regarding oxygen reassessment by educating primary care providers. Post intervention survey will be done in 6 months. CLINICAL IMPLICATIONS Improve oxygen reassessment in patients after discharge with oxygen DISCLOSURES No relevant relationships by Anam Aqeel No relevant relationships by Mansur Assaad No relevant relationships by Apurwa Karki No relevant relationships by Shobha Mandal No relevant relationships by Rajamurugan Meenakshisundaram