Thursday 15 October 2009

Tackling missed opportunities in primary care

Improving quality in primary care is a document that sets out to support PCTs as commissioners of primary care working with local clinicians and other stakeholders – including patients – to promote continuous quality improvement in primary care services. The focus of the document is on the quality of care delivered by the practice rather than the individual practitioners and I was pleased to read about the work of Lisa Eve.

'The information technology (IM&T) team at Sutton and Merton PCT picked up an issue from reviewing CHART & PRIMIS data and discussed this with Lisa Eve, Clinical Services Director and audit lead at Cricket Green Medical Practice. As a result, Lisa conducted an audit, looking at patient records and found that there was a simple READ coding issue. The results from this audit were highlighted as an education and development need within the practice and at their education meeting Lisa ensured all relevant staff within the practice were trained in using the correct READ coding for the condition. As a result all patients who have chronic kidney disease (CKD) now have this long term condition correctly READ coded on the front page of their electronic records. This audit enabled tidying up of patient electronic records by providing an easy to glance record of patient’s current and past problems. The audit also enabled the CKD clinical lead to implement improved clinical care in the form of identifying patients who have not, as yet undertaken annual urine tests for microalbuminuria.

As Lisa says: “this audit enabled us to focus on CKD, improve identification and correct READ coding of CKD and review the need for recruiting specific members of practice staff in order to
deliver targeted clinical care which has the potential to improve patient disease outcomes”.

The audits undertaken were written up, sent to the IM&T team lead at the PCT to enable the review of practice changes and sharing of audit knowledge with other practices.'

One of the things emerging from the Greater Manchester Collaboration for Leadership in Applied Health Research and Care (CLAHRC) CKD project I am involved in locally is the key role that practice managers play in setting up and monitoring the systems that enable the clinicians to improve the quality of care. Practice Managers make a really significant contribution to the health and wellbeing of the nation.