An estimated 10,000 people in our region are living with COPD, and 3,000 of those do not have a primary care provider. Across Canada, COPD is the second leading cause of emergency department visits among adults, many of which are preventable with the right coordinated care.
In partnership with Kingston Health Sciences Centre (KHSC), KCHC’s Regional Lung Health Program is improving access to pulmonary rehabilitation for unrostered patients through an integrated pathway that offers timely assessments and flexible referral options, including self-referral.
Led by Community Physician Dr. Ani Garg, Nurse Navigator Nicola Thomas and Kinesiologist Jonathan Ying, the program brings together an interdisciplinary team working alongside KHSC specialists and trained peer volunteers to improve access to care and strengthen patients’ confidence in managing their condition.
“A key focus of the Regional Lung Health Program is building self-management skills so patients can recognize early symptom changes and respond before they become emergencies,” Nicola explains. “We also connect unattached patients to a primary care provider and a nurse navigator, ensuring more consistent support. Patients also have streamlined access to specialist care when needed, including referrals to the KHSC Rapid Access Respirology Clinic.”
As part of the program, patients receive comprehensive individual assessments, including spirometry testing to support diagnosis and evaluate lung function. The team can additionally support individuals who are currently smoking by connecting them with smoking cessation supports through the STOP program.
The Regional Lung Health Program offers group education sessions prior to a 12-week pulmonary rehabilitation program designed to improve strength, breathing, and overall function. Patients also have access to wrap-around support through our Allied Health Services, including social work, pharmacy, occupational therapy and dietitian support. If in-person education or pulmonary rehabilitation cannot be accommodated, patients can be connected to virtual services within the region. Ongoing follow-up is then tailored to each individual, with regular check-ins in person or by phone, ensuring patients feel supported and empowered every step of the way.
“Over the next few years, our focus is on ensuring that every person living with COPD in our region has access to primary care and the support they need to manage their condition effectively,” Nicola explains. “We want to reduce preventable emergency visits and, ultimately, be recognized as a leader in COPD care by improving access, outcomes, and quality of life across the region.”