Q&A: The COPD Foundation’s Deb McGowan

With penalties approaching, improved communication needed to cut readmissions
Friday, August 1, 2014

WASHINGTON – If it takes a village to raise a child, it takes a community of healthcare providers to keep COPD patients out of the hospital. That will become even more critical Oct. 1, when hospitals start being penalized for excessive readmissions for COPD patients. Deb McGowan, senior director of health outcomes at The COPD Foundation, spoke with HME News about how hospitals and HME providers can work together to curb readmissions.

HME News: You participated in a readmissions survey with Carolinas Healthcare System. What are some of the challenges you found COPD patients face when they are discharged?

Deb McGowan:  Education is a big one: They really don’t understand their disease, and they don’t understand how to use their meds—in particular, nebulizers and inhalers. Lots of patients don’t have doctor’s appointments when they leave the hospital for follow-up. Financial constraints are always a big one, too: People say they can afford their meds but when they get to the pharmacy and they are $300, they can’t afford that. The DME is another piece. They struggle with oxygen and how to use it, when to use it, whether they can go out of their house with it.

HME: What role can RTs play in post-acute care?

McGowan: I’m a firm believer in RTs. I think they are so critical with the COPD patients. They can communicate better than any nurse I’ve seen. They know the inhaler demo better than nurses, better than pharmacists, because they’ve been teaching this for years.

HME: What should hospital RTs and home-based RTs do to best serve patients?

McGowan: In that transition and the handoff of any information, whether back to the primary care physician or specialist or home care or skilled nursing facility, it really has to be as a community unit. We have to share information differently, making sure education is all the same.

HME: How are transition teams doing with that?

McGowan: If we’re talking about probably the majority of people, I don’t think they’re communicating to each other at all—that’s where we saw a real gap. Even nurses to nurses, from hospital to skilled nursing facility, or the RTs at SNFs, we could have easily had that communication and we didn’t.


Who decided hospitals should be punished for COPD readmissions and why? Is this part of the ACA? And won't it lead to hospitals turning COPD patients away to avoid the penalty?