Case study summary
Claremont Medical Practice developed streamlined self-care systems to improve the pathway by creating a self-care system in the practice’s waiting room, which provides contraceptive, asthma and weight checks, as well as a blood pressure monitor. The self-care system was simple to implement and gave sufficient privacy for patients to be confident about using the machines, alleviating their fear of revealing the results in a crowded waiting.
Pill checks and asthma checks were provided in practice, requiring patients who sometimes present very little or no change to their condition to take a GP appointment, which is can be time pressured. Claremont Medical Practice developed streamlined self-care systems to improve the pathway by creating a self-care system in the practice’s waiting room, which provides contraceptive, asthma and weight checks, as well as a blood pressure monitor. The self-care system was simple to implement and gave sufficient privacy for patients to be confident about using the machines, alleviating their fear of revealing the results in a crowded waiting room.
Each time a woman wishes to renew her contraceptive pill a number of questions should be asked, and weight and blood pressure (BP) recorded. Practice staff – in particular GP Partner Dr Joseph Mays – created a clinical online and paper template for patients to record their answers, including answers to questions prompting education and awareness, and use the scales and BP machine in the waiting room. Where problems were identified the patient would be contacted and reviewed.
The asthma form is completed online and questions the patient regarding a number of potential issues. When patients complete their form the answers are coded directly into the notes and the office staff are informed of its completion automatically. In response the long-term condition team are made aware and review the results – if there are any concerns or needs at all a patient appointment is arranged for review.
Regarding the central duty team – the patient first contact team acquires information about the issue, places a summary on the central duty team screen and the nurse and doctor triage to each other collaboratively. they will also triage out into the other skill sets in the practice.
The online forms project has already picked up previously unknown health concerns with the pill such as migraine and family history of problems which have improved patient care and reduced risk. It has also reduced workload for the practice and ensures a complete assessment every time.
The form is available online and in practice. All patients using the contraceptive pill are invited to complete this survey once a year. The asthma form is available online also.
Dr Jim Forrer said: “We realised that a checklist approach to some aspects of care is not only safer and more complete but also more convenient to many patients. Our feedback from patients was great and we extended the scope of the project. Other neighbouring practices have already adopted this approach.
Our GP and nurse practitioner ‘duty team’ work from the central administration office in a more private quarter. This affords appropriate confidentiality for patients whilst giving secretaries, telephonists, district nurses and other clinical staff access to this central team. As a result this area is the heart of the practice and gives the wider team access to a clinical skill set. Of course there’s sometimes a feeling of being interrupted and so we made a clear policy for staff to wait and allow the duty team to finish their consultation write-up or other item of work before presenting their own concern. This works well and overall is efficient as it reduces the time staff spend waiting outside consulting room doors for a signature, prescription, ECG review or discussion.
For further information contact:
Claremont Medical Practice
Tel: 01395 280440