Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

M. Tish Knobf


In 2010, it was estimated that the U.S. spent approximately $50 billion to treat chronic obstructive pulmonary disease (COPD). Nurse-driven interventions are essential in value-based care. The purpose of this quality improvement (QI) project is to reduce the number of preventable COPD-related admissions and emergency department (ER) visits by implementing a telephonic nurse-led evidence-based COPD self-management program. A 50-patient pilot has been initiated. A pre-and-post test will be used to evaluate the effect on preventable hospitalizations and ER visits. If the outcomes of the program are unfavorable, a root cause analysis will be conducted to obtain nursing feedback on perceived barriers to program success. Patients who have had a preventable utilization following the program will be contacted to identify any issues that contributed to the utilization to improve the model of care. The evidence suggests the program will reduce COPD-related inpatient and ER utilization. Neither the literature nor national organizations recommend a specific self-management program, which provides little guidance on the optimal way to foster self-care among COPD patients. The detailed description of our program design using review of the literature and expert panel, specific delivery components, and evaluation criteria will provide foundational strategies to reduced COPD utilization.


This is an Open Access Thesis.

Open Access

This Article is Open Access