scholarly journals The importance of significant event analysis

2020 ◽  
Vol 13 (10) ◽  
pp. 613-617
Author(s):  
Nicola Cooper-Moss ◽  
Neil Smith ◽  
Professor Umesh Chauhan
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Clinical Reasoning ◽  
Healthcare Systems ◽  
Event Analysis ◽  
Quality Improvement Activity ◽  
Primary Care Teams ◽  
Team Based Learning ◽  
Future Patient

Significant event analysis (SEA) is a structured quality improvement activity that is well established in general practice. Participation in SEA prompts primary care teams to reflect on their clinical reasoning, to highlight exemplary care, and to identify any potential improvements in both practice and wider healthcare systems. This article provides an overview of the SEA process and the events surrounding a SEA meeting. Cancer care examples are used to demonstrate how SEA can be used to enhance team-based learning and improve future patient care.

scholarly journals New teams in general practice

2018 ◽  
Vol 11 (9) ◽  
pp. 506-512 ◽  
Author(s):  
Kamila Hawthorne ◽  
Ben Jackson ◽  
Danielle Fisher
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Continuity Of Care ◽  
Healthcare Professionals ◽  
Hospital Admissions ◽  
Healthcare Outcomes ◽  
Complex Patients ◽  
Primary Care Teams ◽  
A Priority ◽  
Parallel Stream

The NHS is seriously under-doctored, with general practice being one of the worst-affected specialties. GPs are a highly trusted and valued profession by patients. In addition, the ‘gatekeeping’ function and continuity of care they provide is critical to the efficiency of the services as a whole, keeps hospital admissions down, and produces better healthcare outcomes for communities and populations. Major efforts are being made to recruit new GPs and retain existing GPs, but there are serious implications for the future of primary care, and general practice in particular, as GPs struggle to cope with increased workloads. Increasing the number of GPs in the workforce is critical, and this work continues as a priority. However, a parallel stream of work has developed to consider ways in which tasks ‘traditionally’ undertaken by a GP might be diverted to new healthcare professionals within primary care teams, freeing up GPs to concentrate on the care and management of their more complex patients.

Can clinical governance deliver quality improvement in Australian general practice and primary care? A systematic review of the evidence

2010 ◽  
Vol 193 (10) ◽  
pp. 602-607 ◽  
Author(s):  
Christine B Phillips ◽  
Christopher M Pearce ◽  
Sally Hall ◽  
Joanne Travaglia ◽  
Simon Lusignan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Clinical Governance ◽  
Australian General Practice

scholarly journals Designing a multifaceted quality improvement intervention in primary care in a country where general practice is seeking recognition: the case of Cyprus

2008 ◽  
Vol 8 (1) ◽  
Author(s):  
George A Samoutis ◽  
Elpidoforos S Soteriades ◽  
Henri E Stoffers ◽  
Theodora Zachariadou ◽  
Anastasios Philalithis ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Quality Improvement Intervention ◽  
Improvement Intervention

scholarly journals Reducing missed appointments in general practice: evaluation of a quality improvement programme in East London

2020 ◽  
Vol 71 (702) ◽  
pp. e31-e38
Author(s):  
Tom Margham ◽  
Crystal Williams ◽  
Jack Steadman ◽  
Sally Hull
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Effective Practice ◽  
Missed Appointments ◽  
Post Intervention ◽  
Primary Care Sector ◽  
Appointment System ◽  
Times Series Analysis ◽  
The Impact

BackgroundMissed appointments are common in primary care, contributing to reduced clinical capacity. NHS England has estimated that there are 7.2 million missed general practice appointments annually, at a cost of £216 million. Reducing these numbers is important for an efficient primary care sector.AimTo evaluate the impact of a system-wide quality improvement (QI) programme on the rates of missed GP appointments, and to identify effective practice interventions.Design and settingPractices within a clinical commissioning group (CCG) in East London, with an ethnically diverse and socially deprived population.MethodStudy practices engaged in a generic QI programme, which included sharing data on appointment systems and Did Not Attend (DNA) rates. Fourteen out of 25 practices implemented DNA reduction projects, supported by practice-based coaching. Appointment data were collected from practice electronic health records. Evaluation included comparisons of DNA rates pre- and post-intervention using interrupted times series analysis.ResultsIn total, 25 out of 32 practices engaged with the programme. The mean DNA rate at baseline was 7% (range 2–12%); 2 years later the generic intervention DNA rates were 5.2%. This equates to a reduction of 4030 missed appointments. The most effective practice intervention was to reduce the forward booking time to 1 day. The practice that made this change reduced its mean DNA rate from 7.8% to 3.9%.ConclusionForward booking time in days is the best predictor of practice DNA rates. Sharing appointment data produced a significant reduction in missed appointments, and behaviour change interventions with patients had a modest additional impact; in contrast, introducing structural change to the appointment system effectively reduced DNA rates. To reduce non-attendance, it appears that the appointment system needs to change, not the patient.

Constructing a framework for quality activity in primary care

2013 ◽  
Vol 37 (1) ◽  
pp. 98 ◽  
Author(s):  
G. A. Roshan Perera ◽  
Anthony C. Dowell ◽  
Caroline J. Morris
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
New Zealand ◽  
Clinical Care ◽  
Care Practice ◽  
Quality Improvement Activity ◽  
Practice Level ◽  
Theoretical Approaches ◽  
Primary Care Practitioners ◽  
Competing Priorities

Introduction. In 2009, the Royal New Zealand College of General Practitioners commissioned the development of a framework to facilitate quality-improvement activity in primary care settings. This paper outlines the development of the framework, which integrates concepts of quality with the reality of practice-based clinical care, and discusses its value for primary care quality improvement. Method. Framework development involved: (1) literature review of theoretical approaches to healthcare quality; (2) field work utilising a mixed methods approach to obtain empirical data; and (3) model design. Results. Primary care practitioners are juggling competing priorities. Models and tools that promote quality-related activity at practice level need to take into account, and incorporate by design, day-to-day clinical and practice functions. Conclusions. The quality framework identifies the components of primary care practice and locates this model within the concepts and activities necessary for quality improvement. It may be used by primary care organisations and practices to facilitate focussed quality-improvement activity and self-directed process review. The framework was developed for, and within a New Zealand primary care setting, and is applicable internationally and within other healthcare settings. What is known about the topic? Primary care practitioners are frequently juggling competing priorities while participating in an array of professional development, quality assurance, and improvement activities, some perceived to be of little relevance to day-to-day clinical care. What does this paper add? The framework integrates concepts of quality with the reality of practice-based clinical care. The function of the framework is to ensure all relevant aspects of practice are considered in a systematic and comprehensive manner to obtain quality improvement. What are the implications for practitioners? The framework is a practical tool that can guide practices and organisational stakeholders to continually deconstruct, examine and reassemble any practice-based clinical care activity. Practices wishing to undertake quality-improvement activity within the context of clinical care may use the framework to guide critical thinking at practice level.

scholarly journals Exploring the feasibility of patient safety huddles in general practice

2020 ◽  
Vol 21 ◽  
Author(s):  
Hannah Panayiotou ◽  
Charlotte Higgs ◽  
Robbie Foy
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Patient Safety ◽  
Online Survey ◽  
Healthcare Systems ◽  
Practice Staff ◽  
Care Structure ◽  
Potential Benefits ◽  
Current Context ◽  
General Practices

Abstract Background: Patient safety is a key priority for healthcare systems. Patient safety huddles have been advocated as a way to improve safety. We explored the feasibility of huddles in general practice. Methods: We invited all general practices in West Yorkshire to complete an online survey and interviewed practice staff. Results: Thirty-four out of 306 practices (11.1%) responded to our survey. Of these, 22 practices (64.7%) reported having breaks for staff to meet and eight (23.5%) reported no longer having breaks in their practices. Seven interviewees identified several barriers to safety huddles including time and current culture; individuals felt meetings or breaks would not be easily integrated into current primary care structure. Discussion: Despite their initial promise, there are major challenges to introducing patient safety huddles within the current context of UK general practice. General practice staff may need more convincing of potential benefits.

scholarly journals Structured yet simple approaches to primary care data quality improvements can indeed strike gold

2021 ◽  
Vol 27 (2) ◽  
pp. 143
Author(s):  
Abhijeet Ghosh ◽  
Elizabeth Halcomb ◽  
Sandra McCarthy ◽  
Christine Ashley
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Quality Improvement ◽  
Data Quality ◽  
Disease Surveillance ◽  
Data Entry ◽  
Structured Interviews ◽  
Improvement Strategy ◽  
Quality Improvement Strategy ◽  
Primary Care Data

General practice data provide important opportunities for both population health and within-practice initiatives to improve health. Despite its promise, a lack of accuracy affects the use of such data. The Sentinel Practices Data Sourcing (SPDS) project is a structured chronic disease surveillance and data quality improvement strategy in general practice. A mixed-methods approach was used to evaluate data quality improvement in 99 participating practices over 12 months. Quantitative data were obtained by measuring performance against 10 defined indicators, whereas 48 semi-structured interviews provided qualitative data. Aggregated scores demonstrated improvements in all indicators, ranging from minor to substantially significant improvements. Participants reported positively on levels of support provided, and acquisition of new knowledge and skills relating to data entry and cleansing. This evaluation provides evidence of the effectiveness of a structured approach to improve the quality of primary care data. Investing in this targeted intervention has the potential to create sustained improvements in data quality, which can drive clinical practice improvement.

Sign in / Sign up

Export Citation Format

Share Document