Last year, a rural health care team jumped into action to better serve their patients; 18 months later, their efforts are making a huge difference to the care provided in Wadena.

In January 2013, the Wadena Primary Health Care team began a project in hopes of developing a systematic approach to managing care and supporting Chronic Obstructive Pulmonary Disease (COPD) patients and clients in acute and primary care.

Information was gathered from projects that had already been started in Saskatoon Health Region, specifically the Rapid Process Improvement Workshop (RPIW) at St Paul’s Hospital in Saskatoon.

The Wadena Primary Health Care team has taken great strides to better help COPD patients in their community.

The Wadena Primary Health Care team has taken great strides to better help COPD patients in their community.

The improvement aim of the project charter was to:
• increase the use of Standardized COPD orders in acute care,
• reduce the length of stay or admission rates for AECOPD patients to Wadena Hospital,
• increase the number of standardized spirometry (breath measuring) testing done by trained professionals,
• improve patient access to standardized education for COPD,
• improve access to exercise therapy or pulmonary rehab, and
• improve patient access to the smoking cessation programming.

By September, a team member was Spirotrec trained and began a monthly spirometry testing clinic. Acute care had already started using the Region’s COPD physician order set in the summer. After a one-hour nursing education session on COPD and the upcoming changes, nursing began using the inhaler device teaching sheets, a new COPD NISS care plan, COPD discharge instructions and action plan.

A new smoking cessation card promoted clients to be informed that “quitting smoking is the single most important thing you can do to improve your health” and how to access help in order to quit. One of those resources is the PACT trained primary care pharmacist.

Home care included the use of the inhaler teaching sheets for their clients and smoking cessation cards were handed out by Public Health nurses to clients/mothers at immunization clinics.

At this point, the team is proud to report some great successes:

• In one year, 99 out of 114 referred clients have had spirometry testing.

• The average length of stay for acute exacerbation of COPD patients has reduced almost 50% from 2012 to 2014.

• Access to standardized COPD education now includes the continuum of Saskatoon Health Region services i.e. spirometry technician, acute care nurse, LiveWell COPD nurse, LiveWell exercise therapist, clinical pharmacist, and home care nurse.

• Since February 2013, 20 clients have been referred for smoking cessation and 75% of them have agreed to one or more sessions for counseling.

The clients this group has served has given some great feedback to the team. “It sure is nice I didn’t have to drive far to have this test done,” is one comment that’s been made. “Thank you so much! I am so glad I will finally have some answers,” was another. A client recently diagnosed with asthma and referred to the CDM program stated, “Who knew, after all these years of being short of breath, there is a treatment that helps me?”

Public Health had a role in expanding the project to the community. A survey of the Grade 10 students revealed an extremely high percentage were tobacco users (this age group has the highest average of tobacco smokers nationally). Public Health followed up the survey with a presentation on the effects of tobacco, including smokeless products as a primary prevention strategy.

“The entire project has truly been a community effort,” stated Loretta MacDonald, RN, Livewell Chronic Disease Nurse.

The efforts of the group were honoured at the Saskatoon Health Region Bravo Recognition night on October 7.