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Fraser Health pilot program helps patients breathe easier
A year ago, John Brodt was in and out of Royal Columbian Hospital every four to six weeks, whenever he struggled to breathe due to Chronic Obstructive Pulmonary Disease (COPD).
He could only walk 40 feet before becoming exhausted, and requiring a refill for his oxygen tank. It got so Brodt was reluctant to leave his New Westminster home.
But that's all in the past, thanks to the BreatheWell at Home Program, a Fraser Health Authority pilot project in Burnaby and New Westminster.
The program started last September as a way to address the high number of hospital admissions for COPD at Royal Columbian and Burnaby hospitals, said Dr. Grace Park, medical director for Fraser Health's home health program.
COPD—the highest risk factor is smoking or exposure to second-hand smoke—has the highest rate of hospital admissions of all the chronic diseases, more than even heart disease and diabetes, Park said.
It's also the fourth leading cause of death in Canada.
When COPD patients find their condition exacerbated, by a viral infection for instance, they have problems breathing and become very fatigued. Once admitted to hospital for treatment, their average stay is 10 days, more if the patient is elderly. Park noted that 38 per cent are admitted several times a year.
In addition to affecting patients' quality of life, such cases are also very costly to the provincial health system.
The idea behind BreatheWell is to educate COPD patients on how to better manage their disease, from learning what could trigger a flare-up to learning how to properly use medications. Patients are given a set of tools to use, including doctor's prescriptions written out in advance, allowing them to look after their symptoms early on, said Park. It's symptoms left untreated for too long that often land patients in the hospital.
And it's all done under the supervision of respiratory therapists and nurses. Patients are all given monitoring equipment that is used daily to check vital signs such as oxygen levels, blood pressure and heart rate. Using a touch-screen device, they answer questions about how they're feeling that day. All that information is sent remotely to a nurse who monitors it, calling patients if they notice anything unusual.
"It really does help patients to become more aware of their condition," Park said.
That awareness has reaped dividends. Since the start of the program, the number of COPD-related hospitalizations has been reduced by 42 per cent, ER use by such patients has gone down 32 per cent, and of those admitted, the length of their stays has been cut by 38 per cent.
With hospital staff aware of patients' participation in the program, they're more comfortable releasing patients a bit early knowing a respiratory therapist will be following up with them within 48 hours, Park said.
The telling statistics showing the program's success have given it the go-ahead to continue in Burnaby and New Westminster, where it will continue to be tweaked to develop efficiencies, she said. Meanwhile, Fraser Health has applied for health ministry funding to expand BreatheWell to two other communities. It should know of a decision by June.
As for John Brodt, 69, his respiratory therapist, Joanne Terry, is amazed at how far he's come.
Noting that a stay in an acute care hospital bed costs $1,000 a day, and Brodt's previous stays lasted seven to 10 days each, Terry told him he'd already saved the health system $100,000 by staying out of hospital the past year.
But perhaps more importantly, his quality of life has seen a huge improvement.
Brodt is no longer as anxious now that he knows he'll likely have more shortness of breath on cloudy and humid days when air pollution is worse. He's learned to pace himself when out walking. And he knows advice and help is just a phone call away.
Just the other day a nurse phoned to check in when she noticed Brodt's pulse was higher than normal through the remote monitoring device, noted his wife, Sonia.
"Our quality of life has turned completely around," said Sonia. "We can basically plan if we want to do something."
With Terry's help, Brodt has gained confidence every time he's reached an increasingly bigger goal.
In one year he's gone from barely being able to walk down the hallway in his house, to driving and walking for a coffee at the Uptown Tim Horton's. They even managed a trip to visit their daughter in Grande Prairie, Alberta, albeit with his oxygen compressor and a couple extra oxygen tanks taking up the trunk of their car.
Brodt can't say enough about the program.
"When I started the BreatheWell program, it was like somebody turned on the light."