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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.
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Step 1 - During a patient review check the patient's MRC score
During a routine COPD review, check the patient's MRC score:
- Not troubled by breathless except on strenuous exercise
- Short of breath when hurrying on a level or when walking up a slight hill
- Walks slower than most people on the level, stops after a mile or so, or stops after 15 minutes walking at own pace
- Stops for breath after walking 100 yards, or after a few minutes on level ground
- 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
MRC 2
- Read code: 173I.
- SNOMED code: 391123006
MRC 3
- Read code: 173J.
- SNOMED code: 391124000
MRC 4
- Read code: 173K.
- SNOMED code: 391125004
MRC 5
- Read code: 173L.
- SNOMED code: 391126003
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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.
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