TPP Workshop - Paul Nathan
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This document discusses improving patient access to information and implementing the Accessible Information Standard. It provides information on: 1. Highlighting communication needs in patient records and sharing those needs with other organizations with patient consent. 2. Starting implementation by running reports to identify patients, training staff, and designing a process for the practice. 3. Potential solutions like status markers, templates, and prompts in clinical systems, as well as sample letters and consent forms. 4. Resources and additional assistance practices may need to address diverse patient information needs.
TPP Workshop - Paul Nathan
- 1. Dr Paul Nathan, GP Patient Access to Information
- 2. • Interest in improving quality of care by better use of our information systems • Passionate about General Practice Who Am I?
- 3. • Remind ourselves about the standard • Look at some of the data from my practice and what this means • Opportunity to discuss around the tables • Consider some process redesign for your practice • Look at Ideas in development • Finally look at practical solutions with suppliers Aim and format for workshop
- 4. • Highlight in patients records that they have communication needs, and explain how those needs should be met • Share those needs with other organisations with consent • Ensure patients have information in accessible way and communication support if they need it Accessible Information Standard
- 7. • Where do we start? • How do we identify patients ? • What processes do we need for new patients? • What do we do for existing patients? Table Discussion
- 8. ProtocolsStatus MarkersAuto-consultations TemplatesRemindersPrompts There are lots of ways of doing things! Flexibility of SystmOne
- 9. • Need for verification of use of codes • Establishment of “disease registers” • Clarification of use of codes • Communication with patients • Sharing information with other organisations Use of Standard
- 10. • How could your practice implement this standard? • What difficulties can you foresee? Table Discussion 2
- 11. 1. Run reports to identify patients who may be appropriate 2. Training staff about standard 3. Design a process which works for the practice 4. Send out letters to identify if there is a need for additional information requirements 5. Act on the letters Where Do You Start?
- 12. RemindersPromptsTemplates Yorkshire is ahead of the game and has provided a solution if you want to use it Solutions to Implementation
- 13. Dear _______________, At this Medical Practice we want to make sure that we give you information in a way that is clear to you. Our records show that you may have a disability that means you find it difficult to read or understand the information that you are given by the Bentham Medical Practice. Is this correct? Yes No Please can you tell us how we need to communicate with you? By phone I use a hearing aid I do not use a hearing aid With a British Sign Language interpreter By email I use a screen reader I do not use a screen reader By text message I use a text to speak app I do not use a text to speak app With Easy Read pictures and words By letter using large type If you need anything that is not on the list above, please tell our receptionist when you come in for your next appointment and we will do our best to meet your needs. Yours sincerely, Letter to Patients
- 14. Patient Information Status Codes
- 15. • Developed by Clinical Support Unit – Tested in four local practices – Developed by • Lucy Speller • Barry Clarke • Des Carter – here today Yorkshire & Humber Prompt
- 16. Yorkshire Prompt Special requirements for access protocol
- 17. • Training requirements regarding coding • All staff aware of the standard • Understanding SCR and additional consent Create templateUse status markersCreate a view Possible Solutions
- 19. Template View
- 22. • Understanding coding issues with this standard • What should be recorded in a medical summary • England and Wales partially sighted certification = 0 • Gaining consent for additional information to be shared with SCR SCR
- 23. What resources do I need to be able to address the patient information needs? • How do I convert to braille? • Use of email from notes? • Text type • Patient online access - results of tests, letters etc. What other solutions do I need? Completing the Circle
- 24. • Letter to patients • Update to new patient questionnaire • Clinical system support • List of appropriate codes • Consent of patients to share this information • Practical provision of services to patient What additional assistance do you need? Practical Support
- 25. Dr Paul Nathan BMedSci., BM.BS., DCH., FRCGP., MSc paul.nathan@nhs.net Any questions?
Editor's Notes
- #2: GP in Derby – working or 22yrs full time Practice has 18,000 patients over 2 sites GP trainer and appraiser Co-founded the national SystmOne user group
- #3: I’m no expert but interested in improving patient care
- #6: We don’t always record Who has hearing aid Who is registered deaf Who requires a sign language interpreter Who can lip read I had request early Feb from a patient who I have email correspondence with who required a counsellor with BLS skills, the local counselling service did not provide this
- #7: Here are more figures about the disease registers we have and the possible patient who will need to be contacted Interestingly despite never knowingly used the “patient information status code” apart from one patient which I have been using for testing things out, we have 12 patients with this code, 10 who do not have any problems with AIS , and the code has been added by previous practices One code added with record of marriage certificate – proof of change of name, another patient had entry 8 x in record but no free text as to why code had been added, other 8 patients no indication for why code added
- #10: The way we record and use information , has implications for how we use that information and to what end Hearing loss may be part of the standard but if patients have hearing aids and don’t need BSL interpreter how do we use the codes Some patients can lip read , but require email correspondence to book and arrange appointments Consent for sharing with other organisations , about not only their communication needs but also the health and social information
- #12: Identifying patients and consider improved coding for this issues All staff need to be aware of changes an implications for records .. What does all this mean Think carefully about process in practice, if reception and admin are trained properly …may be clinicians will not need to be heavily involved in this
- #13: You can design your own processes if you want however Yorkshire in its normal proactive manor has been proactive in trying to assist practices Prepared by clinical support team , which I believe is about to be disbanded .
- #15: When we have information from patients we need to know how to record this information – which codes where is the records is this going to be so we can find it easily and act on it appropriately
- #17: Yorkshire and Humber Clinical Support team have developed a protocol which put a free text reminder on to the home page This informs you of the way in which the patient should communicated It depends how the practice likes to work ……. Whether you like coded information …… whether you would like to search in future fore more detail on patients or happy with high level code in records . It does not therefore offer the opportunity to add a detailed code which would need to be added as well if we are all going to learn how to share this information with other organisations
- #18: What have I been up to in our practice ?
- #23: Looking through things in preparation there was a code for What information belongs in a medical summary – there is no national agreement over contents of medical summary I recently reviewed new patients registering with practice and only 20 % would have an up to date good quality summary . England and Wales partially sighted certification – how many have used this code ? Which means there is re-coding of existing patients There is a process around gaining consent to share information, which will need to be tackled by the practice. Our local area is proposing a process of implied consent – I don’t think this is acceptable
- #24: What do I need to be able to deliver this standard ? I’m still learning how to do all this , and trying to find solutions Printers with A3 paper? Able to convert to Braille? Simplified language and use of pictures? How can we email from notes and record information back into records? How is patient on line going to help facilitate sharing some of this information so patients can see and enlarge type electronically
- #25: Copy of letter to patients Notification containing protocol and templates Lists of codes Details of suppliers of services