Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Mary Ann Camilleri


Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that affects millions of Americans and accounts for close to 700,000 hospitalizations per year. On average, about 20% of patients hospitalized for acute exacerbation of COPD are readmitted to the hospital within 30 days of discharge. The quality of care delivered to COPD patients is often suboptimal and fragmented, contributing to unfavorable patient outcomes, and high rates of readmissions. The purpose of this DNP project was to reduce 30-day readmissions and improve quality of care by developing and implementing a standardized Discharge Care Bundle for COPD patients in the inpatient setting at an urban academic medical center. The COPD Discharge Care Bundle included the following interventions: pulmonary consultation, smoking cessation evaluation, medication reconciliation, spirometry (if not completed within the last year), patient education, and scheduling of a pulmonary follow-up appointment within 14 days of discharge. During the 3-month implementation period, a total of 30 patients were enrolled in the COPD Discharge Care Bundle program. Thirty-day readmissions data were collected for baseline and project timeframes. The readmission rate decreased from 45.5% for the baseline period to 13.3% post-implementation (p=0.01340). This DNP project provides a robust care standardization process that healthcare organizations can adopt and leverage to improve their COPD performance. An opportunity exists to promote best-practice, equitable care, influence clinical behavior, and accelerate the development and implementation of quality improvementefforts by expanding the inclusion of standardized COPD-related measures in all payer pay-for performance models.


This is an Open Access Thesis.

Open Access

This Article is Open Access