ArticleERJ open research2020
National clinical audit for hospitalised exacerbations of COPD.
Article in ERJ open research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Influencing factors of sedentary behaviour in people with chronic obstructive pulmonary disease: a systematic review.BMJ open respiratory research · 2024Pooled it
- Parasternal electromyography in participants with mild or moderate chronic obstructive pulmonary disease in primary care: cohort study to assess technical and clinical application.BMJ open respiratory research · 2026Trial
- Understanding Delivery and Engagement With a Digital Self-Management Intervention for Chronic Obstructive Pulmonary Disease Across Two Clinical Settings: Qualitative Study.JMIR human factors · 2026Article
- Structured Cardiac Assessment and Treatment Following Exacerbations of COPD (SCATECOPD): A Pilot Randomised Controlled Trial.Biomedicines · 2025Article
- Recommendations for Improving Discharge-Related Care Following a COPD Exacerbation: An Expert Panel Consensus with Emphasis on Low- and Middle-Income Countries.International journal of chronic obstructive pulmonary disease · 2025Article
- Quality of Care and Outcomes of Inpatients with COPD: A Multi-Center Study in China.International journal of chronic obstructive pulmonary disease · 2025Observational
- Management of acute exacerbations of COPD in the emergency department and its associations with clinical variables.Internal and emergency medicine · 2024Article
- Development and evaluation of a tool to optimise inhaler selection prior to hospital discharge following an exacerbation of COPD.ERJ open research · 2024Article
- The Management of Acute Exacerbations in COPD: A Retrospective Observational Study and Clinical Audit.Journal of clinical medicine · 2023Article
- Implementing an Evidence-Based COPD Hospital Discharge Protocol: A Narrative Review and Expert Recommendations.Advances in therapy · 2023Review
- Mapping inpatient care pathways for patients with COPD: an observational study using routinely collected electronic hospital record data.ERJ open research · 2023Article
- Identification of key opportunities for optimising the management of high-risk COPD patients in the UK using the CONQUEST quality standards: an observational longitudinal study.The Lancet regional health. Europe · 2023Article
- Does pay-for-performance improve patient outcomes in acute exacerbation of COPD admissions?Thorax · 2022Article
- "NEWS2" as an Objective Assessment of Hospitalised COPD Exacerbation Severity.International journal of chronic obstructive pulmonary disease · 2022Article
- Impact of COVID-19 on Hospital Admissions for COPD Exacerbation: Lessons for Future Care.Medicina (Kaunas, Lithuania) · 2022Article
- CONQUEST Quality Standards: For the Collaboration on Quality Improvement Initiative for Achieving Excellence in Standards of COPD Care.International journal of chronic obstructive pulmonary disease · 2021Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionExacerbations of COPD requiring hospital admission are burdensome to patients and health services. Audit enables benchmarking performance between units and against national standards, and supports quality improvement. We summarise 23 years of UK audit for hospitalised COPD exacerbations to better understand which features of audit design have had most impact.
methodPilot audits were performed in 1997 and 2001, with national cross-sectional audits in 2003, 2008 and 2014. Continuous audit commenced in 2017. Overall, 96% of eligible units took part in cross-sectional audit, 86% in the most recent round of continuous audit. We synthesised data from eight rounds of national COPD audit.
resultsClinical outcomes were observed to change at the same time as changes in delivery of care: length of stay halved from 8 to 4 days between 1997 and 2014, alongside wider availability of integrated care. Process indicators did not generally improve with sequential cross-sectional audit. Under continuous audit with quality improvement support, process indicators linked to financial incentives (early specialist review (55-66%) and provision of a discharge bundle (53-74%)) improved more rapidly than those not linked (availability of spirometry (40-46%) and timely noninvasive ventilation (21-24%)).
conclusionCareful piloting and engagement can result in successful roll-out of cross-sectional national audit in a high-burden disease. Audit outcome measures and process indicators may be affected by changes in care pathways. Sequential cross-sectional national audit alone was not generally accompanied by improvements in care. However, improvements in process indicators were seen when continuous audit was combined with quality improvement support and, in particular, financial incentives.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.