Reyleen Loreto, M.D., on a COPD discharge checklist | CHEST 2026

In this interview, Reyleen Loreto, M.D., discusses research she presented at the CHEST 2026 annual meeting last week that described a quality improvement project that successfully reduced the readmission rate of patients who had been hospitalized for chronic obstructive pulmonary disease (COPD) exacerbations. The project, which included a checklist and guidance from a navigator, reduced the 30-day readmission rate from 27.9% before it was implemented to 18.2% afterward, according to the findings Loreto presented at the meeting, which was held in Phoenix.

Loreto, a third-year resident at St. Joseph’s Hospital in Tampa, Florida, and her colleagues used the Plan-Do-Study-Act methodology across internal medicine units at the 615-bed hospital from July 2025 to February 2026, aiming to bring 30-day readmissions down to 15% or less. Interventions included a standardized COPD discharge checklist, structured inhaler education, care navigator consultation to help schedule follow-up within seven days, greater use of a COPD electronic order set and standardized pulmonary rehabilitation referrals. Among 135 COPD discharges, navigator consultation rose from 44% to 95%, and pulmonary rehabilitation referrals rose from 24% to 45%. The median length of stay of four days stayed the same, and emergency room revisits did not increase.

In this interview Loreto explains that the checklist has two main components. The first, handled by a COPD navigator, covers education about the disease and its symptoms, the COPD zones patients need to know, brochures and videos, inhaler education and coordination with case management to identify barriers early in the admission. The second part is completed by nurses, who reinforce that education and confirm that a pharmacy is listed in the patient’s chart, that medications such as short- and long-acting bronchodilators are prescribed, and that patients set a follow-up appointment with their primary care provider or pulmonologist. Nurses also make sure durable medical equipment such as oxygen, nebulizers or noninvasive ventilation is available after discharge and coordinate with home health or a skilled nursing facility when needed.