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Project steps

Step 1

As part of routine COPD review, identify and code correctly the patient’s MRC score.

Step 2

Refer patients with a score between 3-5 for pulmonary rehabilitation and code accordingly.
[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row el_class="qitaskouterrow"][vc_column][vc_row_inner el_class="qigrey"][vc_column_inner][vc_column_text]Step 1 - During a patient review check the patient's MRC score During a routine COPD review, check the patient's MRC score:
  1. Not troubled by breathless except on strenuous exercise
  2. Short of breath when hurrying on a level or when walking up a slight hill
  3. Walks slower than most people on the level, stops after a mile or so, or stops after 15 minutes walking at own pace
  4. Stops for breath after walking 100 yards, or after a few minutes on level ground
  5. Too breathless to leave the house, or breathless when dressing/undressing
Code the patient's MRC score appropriately: MRC 1
  • Read code: 173H.
  • SNOMED code: 391120009
  • Read code: 173I.
  • SNOMED code: 391123006
  • Read code: 173J.
  • SNOMED code: 391124000
  • Read code: 173K.
  • SNOMED code: 391125004
  • Read code: 173L.
  • SNOMED code: 391126003
[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row el_class="qitaskouterrow"][vc_column][vc_row_inner el_class="qigrey"][vc_column_inner][vc_column_text]Step 2 - Make a referral Identify any patients who are functionally disabled by their breathlessness, i.e. they have a Medical Research Council Dynspnoea Score between 3 and 5. For those patients who have a MRC score between 3 and 5, discuss referral to Pulmonary Rehabilitation and code it accordingly:
  • Read code: 8H7u.
  • SNOMED code: 24461000000105
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Recording your progress

For every patient whose record you change, whether that's recording a patient's MRC score, or referring them to a pulmonary rehabilitation programme, be sure to record this in the 'Progress' section of the QI platform.

Related Resources

QI Project Printable Instructions

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