Transforming care for people with chronic obstructive pulmonary disease (COPD)

An initiative to transform the way people with chronic obstructive pulmonary disease (COPD) are supported in the community is underway across Canterbury.

COPD is chronic inflammatory lung disease that causes obstructed airflow from the lungs, leading to breathing difficulty, coughing, mucus production and wheezing. COPD affects hundreds of thousands of New Zealanders and is the fourth leading cause of death in New Zealand. *

In Canterbury approximately 800 patients per year admitted to hospital with COPD as a primary diagnosis.

The new initiative, called the Day 2 Project, sees people who have been admitted to hospital with COPD given a full assessment which considers the physical, emotional, social and environmental factors linked to their condition. This helps those involved in their care make connections with appropriate services and resources on their discharge from hospital.

Hospital stays for people with COPD can last as little as three days, so this assessment will be carried out from the second day to fit around clinical activity.

Dr Rachel Wiseman, Respiratory and Palliative Care physician and chair of the project said: “Patients with COPD will often arrive at the emergency department because they’re experiencing an exacerbation of their breathing issues.

“This hospital stay can be really stressful, and that increased anxiety impacts the person’s ability to stay calm and manage their breathing. So, while the new model is focused on an intervention at the hospital level, what we really want is to build supports around people in their own communities. This is not only the best solution for the person, but also best for the system.”

The 12-month project, which started in June 2021, is led by a steering group of which half of the members are consumers with lived experience of COPD, working alongside clinicians to develop the new model. The project uses the partnership in design approach, putting people and whānau at the centre of the design of ā tātou (our own) health system and services.

Tania Wood joined the steering group to share her experience and improve the lives of others. She cared for her brother Wayne Thomas Wood, who died of COPD in 2020, at the age of 44.

“I’ve lived the pain of this debilitating disease and watched it destroy my brother. I was his voice, his best friend, his carer, his nurse and sometimes his doctor, his taxi, his cleaner, his cook, his agent and his advocate. My understanding of this disease is intense, but it’s knowledge which can help me bring about change,” said Tania.

The steering group will work with organisations outside of health that can influence the social factors that impact lung health, such as housing and access to nutritious foods and physical activity opportunities. The goal is to reduce the overall admission of people with COPD into hospital by 20 per cent, and readmissions from 20% to 12%.

Heather Brunton, Day 2 Project Lead and Manager of the Canterbury Clinical Network Community Respiratory Team, says having a biopsychosocial assessment on Day 2 of a person’s hospital stay will help create a holistic plan which focuses on more than the physical.

“We can then map connections and resources, use navigators and social connectors, engage the community, and individualise the approach. We want to expand beyond health to embed people within their communities, focus on the social determinants, and use existing resources (health and beyond) to their maximum capacity. 

“The potential benefits are a massive change in the management of COPD, reduced hospital admissions, and a significant culture shift which can be transposed to other settings.”

Find out more about the Day 2 Project and watch videos of our people sharing their stories about living with COPD here

*estimates suggest at least 200,000 (15%) of the adult population may be affected (Asthma and Respiratory Foundation NZ)

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