TY - JOUR T1 - Use of DECAF scoring system to facilitate early discharge in acute exacerbation of COPD patients: a quality improvement project at a district general hospital JF - Future Healthcare Journal JO - Future Healthc J SP - e123 LP - e126 DO - 10.7861/fhj.2020-0097 VL - 8 IS - 1 AU - Iftikhar Nadeem AU - Alexander Light AU - Callum Donaldson AU - Usman Feroze Khatana AU - Dinesh Bagmane AU - Enson Thomas AU - Mohammed Azher Y1 - 2021/03/01 UR - http://www.rcpjournals.org/content/8/1/e123.abstract N2 - Introduction DECAF is a scoring tool that can predict severity in patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Previous research has shown AECOPD patients with DECAF scores of 0–1 are candidates for early discharge.Methods Plan, do, study, act (PDSA) methodology was used. Patients with AECOPD and a DECAF score of 0–1 were included. Notes were retrospectively reviewed for patients for DECAF score, length of stay, 30-day re-admission and 30-day mortality (PDSA cycle 1). A framework to facilitate early discharge for patients was subsequently established. Awareness was increased through teaching sessions, posters and targeted emails. To evaluate our improvements, the same parameters were collected prospectively (PDSA cycle 2).Results DECAF score was assessed for no patients in PDSA cycle 1 (n=20) but was assessed for all patients in PDSA cycle 2 (n=14). Hospital stay was significantly decreased in PDSA cycle 2 (mean 0.29±0.45 days) compared with PDSA cycle 1 (mean 3.71±2.69 days; difference p<0.00001). Thirty-day re-admission and 30-day mortality was not significantly different between two groups.Conclusion DECAF protocol is safe and feasible in the district general hospital setting and can facilitate early discharge for patients with low severity AECOPD without any worrisome effects. ER -