CONQUEST: A Quality Improvement Program for Defining and Optimizing Standards of Care for Modifiable High-Risk COPD Patients

Abstract

Luis Alves,1 Rachel Pullen,2 John R Hurst,3 Marc Miravitlles,4 Victoria Carter,5 Rongchang Chen,6 Amy Couper,2 Mark Dransfield,7 Alexander Evans,5 Antony Hardjojo,2 David Jones,5 Rupert Jones,8 Margee Kerr,5 Konstantinos Kostikas,9 Jonathan Marshall,10 Fernando Martinez,11 Marije van Melle,5 Ruth Murray,5 Shigeo Muro,12 Clementine Nordon,10 Michael Pollack,13 Chris Price,5 Anita Sharma,14 Dave Singh,15 Tonya Winders,16 David B Price2 1EPIUnit - Epidemiology Research Unit, ITR - Laboratory for Integrative and Translational Research in Population Health, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; 2Observational and Pragmatic Research Institute, Singapore, Singapore; 3UCL Respiratory, University College London, London, UK; 4Pneumology Dept, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain; 5Optimum Patient Care, Cambridge, UK; 6Key Laboratory of Respiratory Disease of Shenzhen, Shenzhen Institute of Respiratory Disease, Shenzhen People’s Hospital (Second Affiliated Hospital of Jinan University, First Affiliated Hospital of South University of Science and Technology of China), Shenzhen, Guangdong, People’s Republic of China; 7Division of Pulmonary, Allergy, and Critical Care Medicine, Lung Health Center, University of Alabama at Birmingham, Birmingham, AL, USA; 8Research and Knowledge Exchange, Plymouth Marjon University, Plymouth, UK; 9Respiratory Medicine Department, University of Ioannina School of Medicine, Ioannina, Greece; 10BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK; 11New York-Presbyterian Weill Cornell Medical Center, New York, NY, USA; 12Department of Respiratory Medicine, Nara Medical University, Nara, Japan; 13BioPharmaceuticals Medical, AstraZeneca, Wilmington, DE, USA; 14Platinum Medical Centre, Chermside, QLD, Australia; 15Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, UK; 16USA & Global Allergy & Airways Patient Platform, Vienna, AustriaCorrespondence: David B Price, Observational and Pragmatic Research Institute, 22 Sin Ming Lane, #06-76, Midview City, 573969, Singapore, Tel [phone], Email [email protected]: The COllaboration on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) aims to improve the quality of COPD care in primary care. The CONQUEST target population includes patients diagnosed with COPD, and those undiagnosed but with COPD-like exacerbations, who are at high but modifiable risk of COPD exacerbations, increased morbidity, and mortality. Timely diagnosis and optimized management to reduce these risks is vital. There is a need for a quality improvement program (QIP) that enables long-term improvement of patient clinical outcomes via integration of the program into routine clinical care. Core to the CONQUEST program is the adoption of four specifically designed, globally applicable, and expert-agreed quality standards (QS) for modifiable high-risk COPD patients. Translation of the QS into clinical practice, and implementation of the QIP, is guided by the CONQUEST global operational protocol provided to sites meeting the minimum healthcare system requirements. Initial analyses of current practices are conducted to generate baseline assessments of need within healthcare systems and sites looking to implement the QIP. Implementation is supported by the provision of CONQUEST resources and tools, such as clinical decision support, that promote prompt identification and treatment of patients. Utilization of electronic medical record (EMR) and patient-reported data are integral components of the QIP. Regular, automated collection and analysis of data, combined with a cyclical review of the implementation process, will be conducted for long-term, continuous improvement and health impact evaluation. The CONQUEST QIP will be an important resource in the identification and management of patients with modifiable high-risk COPD. Embedding the CONQUEST QS into routine clinical practice with regular evaluation and feedback will result in long-term quality of care improvement.Keywords: patient-reported outcome, patient-reported information, clinical decision support, primary care, quality standards, integrated care

Keywords

• patient-reported outcome
• patient-reported information
• clinical decision support
• primary care
• quality standards
• integrated care