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Evidence to Improve Care


Care in the Community for Adults

Quality standards are sets of concise statements designed to help health care professionals easily and quickly know what care to provide, based on the best evidence.

See below for a summary of the quality standard or download it for more detailed statements.

Download the Quality Standard

Quality Statement 1: Diagnosis Confirmed With Spirometry
People clinically suspected of having COPD have spirometry testing to confirm diagnosis within 3 months of developing respiratory symptoms.

Quality Statement 2: Comprehensive Assessment
People with COPD have a comprehensive assessment to determine the degree of disability, risk of acute exacerbation, and presence of comorbidities near the time of diagnosis and on an annual basis. The severity of airflow limitation, as initially determined by spirometry testing to confirm diagnosis, is reassessed when people’s health status changes.

Quality Statement 3: Goals of Care and Individualized Care Planning
People with COPD discuss their goals of care with their future substitute decision-maker, their primary care provider, and other members of their interprofessional care team. These discussions inform individualized care planning, which is reviewed and updated regularly.

Quality Statement 4: Education and Self-Management
People with COPD and their caregivers receive verbal and written information about COPD from their health care professional and participate in interventions to support self-management, including the development of a written self-management plan.

Quality Statement 5: Promoting Smoking Cessation
People with COPD are asked about their tobacco-smoking status at every opportunity. Those who continue to smoke are offered pharmacological and nonpharmacological smoking cessation interventions.

Quality Statement 6: Pharmacological Management of Stable COPD
People with a confirmed diagnosis of COPD are offered individualized pharmacotherapy to improve symptoms and prevent acute exacerbations. Their medications are reviewed at least annually.

Quality Statement 7: Vaccinations
People with COPD are offered influenza, pneumococcal, and other vaccinations, as appropriate.

Quality Statement 8: Specialized Respiratory Care
People with a confirmed diagnosis of COPD are referred to specialized respiratory care when clinically indicated, after receiving a comprehensive assessment and being offered treatment in primary care. This consultation occurs in accordance with the urgency of their health status.

Quality Statement 9: Pulmonary Rehabilitation
People with moderate to severe, stable COPD are referred to a pulmonary rehabilitation program if they have activity or exercise limitations and breathlessness despite appropriate pharmacological management.

Quality Statement 10: Management of Acute Exacerbations of COPD
People with COPD have access to their primary care provider or a health care professional in their care team within 24 hours of the onset of an acute exacerbation.

Quality Statement 11: Follow-Up After Hospitalization for an Acute Exacerbation of COPD
People with COPD who have been hospitalized for an acute exacerbation have an in-person follow-up assessment within 7 days after discharge.

Quality Statement 12: Pulmonary Rehabilitation After Hospitalization for an Acute Exacerbation of COPD
People who have been admitted to hospital for an acute exacerbation of COPD are considered for pulmonary rehabilitation at the time of discharge. Those who are referred to a pulmonary rehabilitation program start the program within 1 month of hospital discharge.

Quality Statement 13: Palliative Care
People with COPD and their caregivers are offered palliative care support to meet their needs.

Quality Statement 14: Long-Term Oxygen Therapy
People with stable COPD who have clinical indications of hypoxemia receive an assessment for and, if needed, treatment with long-term oxygen therapy.

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