ARGYLL AND BUTE Practice Administrative Staff Collaborative 4 GP - - PowerPoint PPT Presentation

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Feb 20, 2023 10 likes •166 views

ARGYLL AND BUTE Practice Administrative Staff Collaborative 4 GP Cluster Teams/Cluster Quality Leads Helensburgh Oban and Mid Argyll Cowal and Lomond surrounding areas Dr Rebecca Dr Alida Dr Ewan Glen Dr Nick Dunn Helliwell MacGregor

SLIDE 1

4 GP Cluster Teams/Cluster Quality Leads

Oban and surrounding areas Dr Ewan Glen 7 GP Practices Mid Argyll Dr Rebecca Helliwell 7 GP Practices Cowal Dr Alida MacGregor 7 GP Practices Helensburgh and Lomond Dr Nick Dunn 5 GP Practices

ARGYLL AND BUTE

Practice Administrative Staff Collaborative

SLIDE 2

A&B is a “geographically challenging area”

4 localities
6 Cluster Groups
9 Locality Planning

Groups

33 GP Practices
96 GPs
4 GP run Community

Hospitals, including A&E

VOL GP support for

OOH

Islands (25 inhabited)
89,000 Population

SLIDE 3

Areas for Collaboration/ Improvement

VC facilities in all GP practices Phone management Physio role Acute Pharmacy role Meds rec What else NP Visits NP Anticipatory Care Document Management NP undifferentiated illness Quality improvement tools Patient & other stakeholder communication

SLIDE 4

Core areas v Opportunities

Core

1. Reducing Docman by > 50% 2. Nurse Practitioner

a. Increased House visits b. Increased role in Undifferentiated Illness c. Improved Anticipatory Care Planning

Opportunities

1. Extended NP Role 2. Physiotherapy role in Acute presentation 3. Pharmacology role in IDLs etc 4. Increased use of targeted Phone Consultations

SLIDE 5

Risks

Not focussing on Core areas and being distracted by

mission creep

GPs / Practices being overwhelmed by service

provision

Inability to recruit GPs – Increasing Practice Stress
Inability to recruit adequate calibre of NP /AHPs
Lack of funding for support staff
Resistance to change from AHPs
Inadequate measurement of change

SLIDE 6

Core 1:Reducing Volume of Docman

Month 1: Communicate aim / Identify “Champions”
Month 2: Listen to stakeholders / Assess Baseline

workload / Learn from other areas/

Month 3: Formulate Plan / Implement early wins
Month 4: Training manual
Month 5-6: Training
Month 7: Implementation
Month 9: Assessment

SLIDE 7

House visits: Target 50% Reduction
Undifferentiated illness:

1. Who to see – Infections/ Dermatology/Depression

Anticipatory Care Planning:

1. Improve quality and targeting 2. Clearer training and protocols 3. Improve measurement of where we are 4. Role of DNs/ NH Staff

Core 2: Nurse Practitioner Role

SLIDE 8

Liaise with existing physio service in Rothesay
Identify unmet need by consultation analysis
Negotiate with Physio for Acute Physio time
Look to implement and assess in practices
Formulate recommendations for development of

service across locality

Development of Acute Physio Role

SLIDE 9

IDLs: Target - All complex IDLs requiring change are

completed by pharmacist

WHERE NEXT
Special Requests: Target overall reduction in volume
f special requests and increase number done by

pharmacist?

Improving medication review strategies and

recording of reasons for prescriptions / review arrangements?

Pharmacology Role

SLIDE 10

We have a Practice which uses these extensively
Which patients offer the greatest opportunity for this

and how can these by identified by reception staff

Can this be rolled out across other practices within

the cluster

Phone Consultations

SLIDE 11

200 Letters and Results

Pilot Mail workflow project

20% 56% 4% 7% 6% 6% 5%

Pilot breakdown of volume of mail per area

Results * Clinic * IDL * FDL AE OOH Other

SLIDE 12

Pilot Mail workflow project

All incoming mail (100%) Results (20%) Letters (80%)

Pilot

Results * Clinic * IDL * FDL AE OOH Other Total

Estimate

20% 56% 4% 6% 5% 6% 5% 100% 1st

Completed

1st

Completed

1st

Completed

1st

Completed

1st

Completed

1st

Completed

1st

Completed

1st

Completed

Admin Docman Lead 11 36 2 4.5 3.5 3 2.5 62.5 Pharmacy Clinician 8.5 20 2 1 1 2.5 2.5 37.5 100 % by Docman Lead 56% #DIV/0! 64% #DIV/0! 50% #DIV/0! 82% #DIV/0! 78% #DIV/0! 55% #DIV/0! 50% #DIV/0! 63% #DIV/0! 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Results * Clinic * IDL * FDL AE OOH Other Total

Pilot - Estimate % Mail that could be completed by Docman Lead

Average 63% Target 50%

SLIDE 13

200 Letters and Results

Pilot Mail workflow project

Estimated Mail Volume & Hours Per Patient Per 9,300 pt Practice Per 84,301 Cluster Mail per week 0.2 1,920 17,400 Mail per year 11 100,000 906,400 Hours per year (10 minutes) 1666 Hours 15,100 Hours Hours per week 32 Hours 290 Hours

SLIDE 14

Pilot Mail workflow project

WORKFLOW ALGORITHM

All Mail scanned by ADMIN or arrives electronically and -> Patient notes LOMOND and ARGYLL See Appendix for Descriptors (1-9) Letters Results Detailed letters(1) Very Simple letters(2) Normal Results(3) Abnormal Results(4) COMPLETED by ADMIN

DOCMAN LEAD

Simple letter(5) Coding required(6) (No meds change) .+/- Simple Meds Change(7) Complex Meds Change(8) Code if req Important Letter(9) Actioned by DOCMAN LEAD PHARMACIST Simple letter(5) Important Letter(9) COMPLETED by DOCMAN LEAD Named CLINICIAN COMPLETED by CLINICIAN Admin for Action or feedback to Docman Lead or Pharmacist. Either Complete or return to named clinician.

SLIDE 15

1 week of “Normal Results” being filed directly

Pilot Mail workflow project

Results after implementation of Normal results filed by admin (9,300 patient practice) 387 Results per week GP Practice Nurse Pharmacist Total Annual Requested by 253 88 46 387 20,124 Filed directly by admin 92 (36%) 47 (53%) 25 (54%) 164 (42%) 8,528 Seen by Clinician 161 (64%) 41 (47%) 21 (46%) 223 (58%) 11,596