COPD Bundle to Prevent Hospital Readmissions and ED Visits.

Th e search for interventions to reduce avoidable readmissions aft er an exacerbation of COPD has attracted substantial attention aft er the Centers for Medicare & Medicaid Services included COPD exacerbations in its Hospital Readmissions Reduction Program. 1 We read with great interest the study by Jennings et al 2 in a recent issue of CHEST (May 2015) and applaud the authors for conducting a randomized clinical trial to test the eff ects of a predischarge care bundle. Th e study demonstrated a numerically lower but not statistically signifi cant risk of 30-day readmissions or visits to the ED in the intervention group (risk diff erence, 2 3.4%; 95% CI, 2 15.7% to 8.8%). Th e authors acknowledged several potential limitations in the study design, including relying on the primary team to implement interventions directed at risk factors identifi ed by the researchers and the selective eligibility criteria.