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Project steps

Step 1

[/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 - Identify your COPD register

Identify every patient on your COPD register by running a search. The recommended codes for the diagnosis of COPD is:

• Read code: H3...00
• SNOMED code: 13645005

There will be variation between practices.[/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 - Check all patients for evidence of COPD diagnostic testing

Sort your COPD patients by those who have the correct code for post-bronchodilator spirometry:

• Read Code: 339m
• Or SNOMED code: 407603001

Also check that they have the correct FEV1/FVC ratio recorded, and this result is less than 0.7. This should be a decimal number, not a percentage.

• For example, 0.65
• NOT 65%

If the patient does have the correct code for post-bronchodilator spirometry AND a ratio recorded less than 0.7, this confirms their diagnosis of COPD. No further action required.

If the patient does not have the correct code for post-bronchodilator spirometry AND/OR does not have a FEV1/FVC ratio recorded less than 0.7, they may be misdiagnosed and should be reviewed. Click through the dropdown menu below for more details.[/vc_column_text][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][vc_row][vc_column][vc_tta_accordion active_section="0" collapsible_all="true"][vc_tta_section title="Scenario 1: Correct spirometry code, missing FEV1/FVC ratio" tab_id="1614005719562-799eea7b-bf9e"][vc_column_text]For those patients who DO have the correct code for post-bronchodilator spirometry (either a Read Code or SNOMED code), check that they have the correct FEV1/FVC ratio recorded. This should be a decimal number, not a percentage.

• For example, 0.65
• NOT 65%
• To convert a percentage to a ratio, divide by 100.

If the ratio is missing or in the wrong format, go into the patient's records, locate the patient's FEV1/FVC ratio in their spirometry test result, and amend the ratio to ensure it is a number starting with 0. (e.g. 0.34).[/vc_column_text][/vc_tta_section][vc_tta_section title="Scenario 2: Correct spirometry code, incorrect FEV1/FVC ratio" tab_id="1614007801075-37b13c21-2c13"][vc_column_text]For those patients who do have post-bronchodilator spirometry in their notes, but the FEV1/FVC ratio is greater than 0.7, remove the patient from your COPD register and invite the patient in for a review of their diagnosis.[/vc_column_text][/vc_tta_section][vc_tta_section title="Scenario 3: No spirometry code or incorrect spirometry code" tab_id="1614007814682-8aed3a7d-138e"][vc_column_text]For those patients who DO NOT have the correct code (either a Read Code or SNOMED code) for post-bronchodilator spirometry, check whether they have ANY record of spirometry.

Where there is evidence of post-bronchodilator spirometry, change the code:

• Read Code: 339m
• SNOMED code: 407603001

Where there is no evidence of post-bronchodilator spirometry, ensure this patient is invited to perform post-bronchodilator spirometry in their next consultation (see the next QI project for more details).[/vc_column_text][/vc_tta_section][/vc_tta_accordion][/vc_column][/vc_row][vc_row el_class="qitaskouterrow"][vc_column][vc_row_inner el_class="qiaqua"][vc_column_inner][vc_column_text]

Recording your progress

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