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Respiratory Collaborative 12th November 2015
COPD Dashboard Update Jo Congleton
KSS AHSN Respiratory Clinical Lead
2014-15 Influenza Outbreak
• Winter characterised by early influenza activity, with
A(H3N2) virus the dominant circulating sub-type.
• By week 4 2015 peak influenza activity levels had
exceeded those seen in the past three seasons.
• Led to large numbers of care home outbreaks, often
in highly vaccinated populations, hospitalisations and
significant excess all-cause mortality in the over 65
year-old population.
Eurosurveillance, Volume 20, Issue 5, 05 February 2015Rapid communicationsLOW
EFFECTIVENESS OF SEASONAL INFLUENZA VACCINE IN PREVENTING
LABORATORY-CONFIRMED INFLUENZA IN PRIMARY CARE IN THE UNITED
KINGDOM: 2014/15 MID–SEASON RESULTSR G Pebody
• Found overall VE in preventing influenza in
primary care was 3.4%
• −2.3% specifically against A(H3N2)
• Also found clear evidence of antigenic and
genetic mismatch between circulating
A(H3N2) viruses and the 2014/15 northern
hemisphere vaccine strain.
PHE Report
• Effectiveness of the adult flu vaccine
influenza A : 29.3%
• Effectiveness of the adult flu vaccine
against influenza B was 46.3%
0
5
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Q1
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Q2
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Q3
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Q4
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/16
Q1
Admissions per 1000 COPD population*
Total Kent and Medway
0
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20
25
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/09
Q1
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1 Q
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/15
Q1
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Q2
14
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Q3
14
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Q4
15
/16
Q1
Admissions per 1000 COPD population*
Total Surrey
0
5
10
15
20
25
08
/09
Q1
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/09
Q2
08
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Q3
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Q4
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Q1
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Q4
10/1
1 Q
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10
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Q2
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/12
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Q4
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Q2
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Q3
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Q4
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/15
Q1
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/15
Q2
14
/15
Q3
14/1
5 Q
4
15
/16
Q1
Admissions per 1000 COPD population*
Total Sussex
The Seasonal Surge
Total Kent and Medway Total Surrey Total Sussex
Total Sussex quarterly actual
Rolling 12 month average
Total Kent Surrey Sussex
0
5
10
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25
30
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Q1
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Q2
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Q3
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Q4
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Q1
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Q4
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Q1
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Q4
14
/15
Q1
14
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Q2
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/15
Q3
14
/15
Q4
15
/16
Q1
Admissions per 1000 COPD population*
Total Kent and Medway
0
5
10
15
20
25
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/09
Q1
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Q2
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/09
Q3
08
/09
Q4
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/10
Q1
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Q2
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Q3
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/10
Q4
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/11
Q1
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Q2
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Q3
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Q4
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Q1
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Q2
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Q3
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Q4
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Q2
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Q3
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Q4
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Q1
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Q2
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Q3
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/14
Q4
14
/15
Q1
14
/15
Q2
14
/15
Q3
14
/15
Q4
15
/16
Q1
Admissions per 1000 COPD population*
Total Surrey
0
5
10
15
20
25
08
/09
Q1
08
/09
Q2
08
/09
Q3
08
/09
Q4
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/10
Q1
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Q2
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Q3
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Q4
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/11
Q1
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Q2
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Q3
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Q4
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Q1
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Q2
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Q3
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Q1
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Q2
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Q3
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Q4
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Q1
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Q2
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Q3
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Q4
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/15
Q1
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Q2
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Q3
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Q4
15
/16
Q1
Admissions per 1000 COPD population*
Total Sussex
KSS COPD Bed Days
0
10000
20000
30000
40000
50000
60000
Kent Surry Sussex Total
Bed
Days
2010/11
2011/12
2012/13
2013/14
2014/15
Admissions
How could we cope with the
seasonal surge?
• Employ more staff in Q4
• Stop doing some activities in Q4
• Offer flexible hours contract
• Do everything possible to reduce effect: • IBIS care plans
• Influenza vaccination
• PEPR
• Self Management plans
• COPD Discharge Bundle
Care Bundles
• Developed by the Institute for
Healthcare Improvement to help
healthcare providers more reliably
deliver quality patient care
• Elements are accepted best practice
and have been demonstrated to make a
difference to patient outcomes
The 30-day readmission rates before and after the initiation of the chronic obstructive
pulmonary disease discharge care bundle.
Hopkinson N S et al. Thorax 2012;67:90-92
Copyright © BMJ Publishing Group Ltd & British Thoracic Society. All rights reserved.
COPD Discharge Bundle Elements
Referral to smoking cessation service if a current smoker
An assessment of suitability for and enrolment into a pulmonary rehabilitation programme
Provision of written information and rescue packs for future exacerbations
Ensure that patient can demonstrate good inhaler technique whilst on the wards
Ensure that they have appropriate follow up once discharged from hospital
JP