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BTS COPD discharge care bundle: 2016

Posted on: 29 Aug 2017

The purpose of care bundles is to ensure that every patient receives the best possible care every time. Their value in reducing hospital standardised mortality across 13 diagnoses has been demonstrated in UK hospital settings.1

A care bundle:

  • is a structured way of improving care and patient outcomes
  • is a small set of evidence-based interventions which form a cohesive unit of actions that must all be completed to achieve best outcomes
  • focuses on how care is provided as much as on what care is delivered
  • is easy to monitor
  • allows a focus on a small number of measurable strategies aimed at improving specific outcomes
  • allows standardisation of practices and reduces variation in treatment of patients
  • is easy to develop but challenging to implement. One aid is the PDSA cycles: plan, do, study, act.

The National COPD Audit Programme is hosting four quality improvement workshops during 2017. A link to the website is given below (link three).

In a study piloted by the British Thoracic Society (BTS), over a 13-month period between November 2012 and December 2013, data were collected on the outcomes of care for 11,748 patients admitted with acute exacerbation COPD (AECOPD). The study showed that care bundles had an impact on processes of care and on important measurable clinical outcomes:2

  • A statistically significant reduction in mortality from AECOPD was observed in patients in whom oxygen was prescribed at admission and in whom care was delivered within four hours of admission
  • The presence of an oxygen prescription was associated with a reduction in length of stay.

There are five elements to a COPD discharge care bundle: TAPSS – technique (inhaler), action plan, pulmonary rehabilitation, smoking cessation and specialist follow-up. COPD discharge care bundles have been associated with a reduction in the 30-day readmission rate and improved compliance with key processes of care, such as screening patients for and offering smoking cessation.3



  1. Robb E, et al. Using care bundles to reduce in-hospital mortality: quantitative survey. BMJ 2010;340:c1234
  2. Calvert J, et al. British Thoracic Pilot Care Bundle Project: a care bundles-based approach to improving standards of care in chronic obstructive pulmonary disease and community acquired pneumonia, 2014. BTS Reports Vol 6, No 4
  3. Hopkinson NS, et al. Designing and implementing a COPD discharge care bundle. Thorax 2012;340:90-2
BTS care bundles for COPD BTS COPD discharge care bundle: 2016 COPD audit: regional QI workshops

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