You are the operational manager for respiratory medicine at a 300-bed general hospital. Emergency admission rates for chronic obstructive pulmonary disease (COPD) at your hospital are the highest in...

You are the operational manager for respiratory medicine at a 300-bed general hospital. Emergency admission rates for chronic obstructive pulmonary disease (COPD) at your hospital are the highest in your region. The community COPD specialist nurse, who treated people with symptom exacerbations in the community, recently retired and has not been replaced and a local audit by a public health trainee reported poor adherence by GPs and hospital doctors to best practice guidelines. In addition, there have been several complaints by patients with COPD about the quality of hospital care they received during recent exacerbations of their condition with disjointed follow-up and no information on the medicines they were meant to take. What can you do?