PT  - JOURNAL ARTICLE
AU  - Iftikhar Nadeem
AU  - Alexander Light
AU  - Callum Donaldson
AU  - Usman Feroze Khatana
AU  - Dinesh Bagmane
AU  - Enson Thomas
AU  - Mohammed Azher
TI  - Use of DECAF scoring system to facilitate early discharge in acute exacerbation of COPD patients: a quality improvement project at a district general hospital
AID  - 10.7861/fhj.2020-0097
DP  - 2021 Mar 01
TA  - Future Healthcare Journal
PG  - e123--e126
VI  - 8
IP  - 1
4099  - http://www.rcpjournals.org/content/8/1/e123.short
4100  - http://www.rcpjournals.org/content/8/1/e123.full
SO  - Future Healthc J2021 Mar 01; 8
AB  - 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.