General Practice QI

QI projects which have been taken forward in General Practice.

Emma Ross - HRT Reviews (2.0 MiB)
Upload Date: 9th December 2019 Downloads: 12
Aim:


  • In 2011 there were >11 million woman over the age of 45 in the UK

  • When going through the menopause 75% of these woman will have vasomotor symptoms

  • NICE recommend that we offer HRT to help control these symptoms

  • Woman should have a 3 month review of symptom control and annual review thereafter

  • This subsequently allows for review of other measures such as blood pressure and weight


Aim:

By May 2019 I want to ensure that 75% of women commenced on HRT by Dalriada Family Practice are followed up at 3 months adn hoping this will lead to better follow-up at 1 year


Improving Cardiovascular Risk Assessment In Psoriasis Patients (0.5 MiB)
Upload Date: 4th July 2019 Downloads: 56
Aim: Improve the number of psoriasis patients >35 years old having a complete cardiovascular risk assessment to a standard of 50% in 6 months


James Armstrong - Improving Antibiotic Prescribing In Sore Throats (1.2 MiB)
Upload Date: 9th December 2019 Downloads: 9
Aim: Improve the use of the FeverPain score to 80% in sore throat consultations in Gronve Medical Practice.


James Dickson - We're All Going On A Bisphosphonate Holiday (0.9 MiB)
Upload Date: 9th December 2019 Downloads: 10
Aim: Aim

To ensure that all patients on bisphosphonate therapy have an up to date DEXA and FRAX score
to allow consideration of drug holiday if appropriate and reduce inappropriate bisphosphonate therapy

Target: 100% of patients to have had DEXA at 5 years, and recalculation of treatment based on
FRAX score, NOGG guidance and clinical pict


JAMES LAMONT - Methotrexate - Limiting Unnecessary Blood Tests (3.2 MiB)
Upload Date: 9th December 2019 Downloads: 10
Aim: Aim

To reduce the amount of unnecessary blood testing for patients on oral methotrexate.
Aiming for a 25% reduction by May 2019


Jasmine Holland - A Wee Project (0.7 MiB)
Upload Date: 9th December 2019 Downloads: 12
Aim: Aim

•To half the number of contacts from a selected nursing home due to suspected urinary tract infection.
•To completely eliminate the use of urinalysis as an investigation.
•All patients receive 1st or 2nd line antibiotics as per NICE. Any deviation from this should be based on MSU sensitivities.


Jennifer Murphy - Cardiovascular Risk Assessment In Patients With Gout (1.9 MiB)
Upload Date: 9th December 2019 Downloads: 16
Aim: Aim

By April 2019, 60% of patients diagnosed with gout will have a cardiovascular risk assessment.


Jill Mackay - Improving The Management Of Gout (2.0 MiB)
Upload Date: 9th December 2019 Downloads: 9
Aim: Aims

•To achieve a uric acid level of <400 in 50% patients over the next 6 months
•Annual U+E in 100% of patients
•Annual uric acid in 100% of patients
•Completion of gout template in all patients


John Foster - Reducing Opioid Prescribing In Primary Care (2.4 MiB)
Upload Date: 9th December 2019 Downloads: 10
Aim: Aim

Reduce the number of patients using greater than 120mg of Morphine equivalent by 20% over a 6 month period.

 

 


John Treacy - Management Of New AF Diagnosis (2.3 MiB)
Upload Date: 9th December 2019 Downloads: 9
Aim: Aim

To increase the adherence to the practice template to 100% within 3 months.
To ensure safe and efficient management of all new AF patients.
Improvement


Jordan Allen - Hyperkalaemia Management In Primary Care (1.0 MiB)
Upload Date: 9th December 2019 Downloads: 9
Aim: Aim

To improve recording and management of patients with Hyperkalemia

 

 


Judith Simpson - Making A Dent In The Opioid Crisis (2.7 MiB)
Upload Date: 9th December 2019 Downloads: 10
Aim: Aim

To reduce the prescribing of co-codamol 30/500 by 30% in a cohort of 30 patients in Montalto Medical Centre. This will take place over an 8 month period.


Laura Crowley - Hormone Replacement Therapy Annual Review (2.6 MiB)
Upload Date: 9th December 2019 Downloads: 15
Aim: Aim

To improve Hormone Replacement Therapy prescribing and patient safety by carrying out annual review in 80% of women taking HRT by May 2019


Laura Gibson - Supplementing Change (2.6 MiB)
Upload Date: 9th December 2019 Downloads: 10
Aim: Aim

In the population of patients on supplements in a local NH, the aim was to increase the percentage who have had a appropriate dietetic review by 50% in 6 months.


Laura-Jo Hanna And Drew Carlisle - Click & Easy (2.0 MiB)
Upload Date: 9th December 2019 Downloads: 10
Aim: Aim

To increase awareness and usage of the online ‘patient access’ system and app for ordering repeat prescriptions.


Our aim was to increase online orders to 20% by May 2019.


Lisa Dixon - Antidepressant Follow Up (1.1 MiB)
Upload Date: 10th December 2019 Downloads: 10
Aim: AIM

80% of patients to be reveiwed by GP within one month of Antidepressant initiation or dose change due to a new episode or first diagnosis of depression.


Louise McIlwaine And Durga Chakravarty - Repeat Scripts - Improving Safety And Efficiency (2.0 MiB)
Upload Date: 10th December 2019 Downloads: 9
Aim: Aim

To reduce the number repeat prescription requests via the telephone by 70%.


Lucy Hodkinson - Huddles In Primary Care - Promoting Healthy Team Dynamics (1.9 MiB)
Upload Date: 10th December 2019 Downloads: 9
Aim: Aim

To introduce huddle within practice

To improve operational fluency within team

To reduce hierarchy

To promote collective leadership

To promote “joy in work”

To improve patient outcomes


Lyali Banat - Contraception And Amber List Drugs (2.3 MiB)
Upload Date: 10th December 2019 Downloads: 9
Aim: Aim

To improve the percentage number of females of child bearing age, on amber list drugs who are using effective contraception to 85% by April 2019.

 


Lynette Nesbitt - Improving The Care Of Patients With Previous Gestational Diabetes (2.4 MiB)
Upload Date: 10th December 2019 Downloads: 9
Aim: Aim

To improve care of patients who have had Gestational Diabetes in Pregnancy ensuring that at least 80% of these ladies have an annual HbA1c


Lynsey Woods - Pigmented Skin Lesions (2.7 MiB)
Upload Date: 10th December 2019 Downloads: 9
Aim: Aim

To improve accuracy of recording of examination of pigmented skin lesions using NICE ‘Weighted 7 point Checklist’, aiming for 75% of red flag referrals to dermatology for pigmented lesions within the Reid Practice, Bangor Health centre, to have recorded all 7 features of checklist in 3 months time.


Manus McCaughey - Type 2 Diabetes (1.2 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

Make and record a decision regarding Diabetic Drug commencement/escalation /review at
80% of diabetes review consultations where indicators suggest a decision should be made
(also plan suitably timed review)


Michael McQuillan - Thats GOUT To Hurt (1.2 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

75% of patients presenting with a suspected or confirmed flare up of gout ( first presentation of reoccurrence ) will be managed based on the current guidelines by May 2019


Michelle Godfrey - Improving Oral Contraceptive Pill Checks (2.7 MiB)
Upload Date: 10th December 2019 Downloads: 9
Aim: Aim

•To use a standardised ‘Pill Check’ proforma to ensure all essential criteria documented & also to prompt reminder for LARC & STI discussion.

•To make a user friendly proforma on EMIS WEB, based on FSRH UKMEC criteria

•Aim for all oral contraceptive pill checks (COCP & POP) to be coded as ‘Pill Check’ & aim for 80% compliance of documenting outlined criteria


Neil Anderson - Self Referral Maternity Services (3.0 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

To improve awareness amongst the practice population of the option of self referral to maternity services.

Aiming to reduce face to face appointments with GP’s in routine ante-natal referrals by 75%.

Try to ensure continued safe practice even if using self referral.


Oliver PLunkett - Improving AF Detection (0.7 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

To improve the practice of ‘pulse checking’ by 50%, for those patients ≥ 65 years with Hypertension


Patrick Winiger - Management Of Patients Over 75yrs On Aspirin Therapy (0.5 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

To improve the number of patients over the age of 75yrs taking aspirin being co-prescribed a PPI in practice.


Peter Doherty - Minimising Trimethoprin Usage In Patients Prescribed Methotrexate (2.6 MiB)
Upload Date: 10th December 2019 Downloads: 12
Aim: Aim

Aim To review how many patients currently on Methotrexate had been prescribed Trimethoprim in the past 6 months

To raise awareness of the interaction between the two medications

To reduce co-prescribing events to zero and adhere to NI Medicines Governance “Medication Safety Today” Alert 2015*


Peter Farnon And Shazia Masood - The Milky Way (2.7 MiB)
Upload Date: 10th December 2019 Downloads: 10
Aim: Aim

To ensure correct prescription of hydrolysed milk in patients with Cow’s Milk Protein Allergy within the practice – our aim is to achieve 90% correct prescription within a three month period.


R Caffrey And M Cronin - Revisiting The Postnatal Visit (3.9 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

80% of all women attending their postnatal visit will have this new postnatal bundle completed,within the next six months


Rachel Finch - Improving The Followup Of Gestational Diabetes In Springfield Rd Surgery (16.9 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

75% of females with a diagnosis of gestational diabetes will have had a HbA1c within the past 12
months by June 2018

As per NICE guideline [CG63] ‘Diabetes in pregnancy’


Rachel McCrabbe - Hypertension - More Than Just Managing The BP (1.1 MiB)
Upload Date: 10th December 2019 Downloads: 12
Aim: Aim 

To improve the assessment of cardiovascular risk adn end organ damage in 75% of patients diagnosed with hypertension by end of May 2019


Rachel O'Hare - Keep In Touch With The Times (2.6 MiB)
Upload Date: 10th December 2019 Downloads: 12
Aim: Aim

Update patient records with correct mobile numbers and use text message reminder service to improve DNA rates by 5% over first 4 months.


Rory McKeown - Improving The Management Of Patients With NAFLD (19.4 MiB)
Upload Date: 10th December 2019 Downloads: 15
Aim: Aim

80% of Type 2 diabetics, seen at the diabetic clinic, with confirmed NAFLD, will have a
NAFLD Fibrosis (within the last 3 years) score by May 2019. This test should then be
repeated every three years.


Ruth Beringer - Improving The Efficacy Of POP Prescribing (2.8 MiB)
Upload Date: 10th December 2019 Downloads: 10
Aim: Aim

To standardise the quantity of progestogen-only pill prescribing to a minimum quantity of 168 tablets per prescription and achieve this for 75% of patients on the Cerelle POP in this practice.


Ruth Moffett - Improving The Allocation Of Spirometry Appointments (3.1 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

Improve the allocation of Spirometry appointments to avoid wasted appointments

Ensure 100% of Spirometry requests areappropriate


Sarah Cassidy - Improvement Of Prescription Of Emergency Contraception In Line With Current Guidance (2.8 MiB)
Upload Date: 10th December 2019 Downloads: 10
Aim: Aim

To aim improve compliance of recommended guidelines in emergency contraception consult through documentation of weight/BMI with dose as required based on findings. Aiming for 70% of consults to have this clearly documented.


Sarah Cassidy - Improvement Of Prescription Of Emergency Contraception In Line With Current Guidance (2.8 MiB)
Upload Date: 10th December 2019 Downloads: 0
Aim: Aim

The aim of the project was to review all of the female parents of child bearing age taking Amber List Drug medications

The target was to have 90% of these parents counselled regarding Long Acting  Reversible
Contraception [LARC] and prescribing this where required as per FSRH guidance


Sian Darrah - Microscopic Haematuria (2.3 MiB)
Upload Date: 10th December 2019 Downloads: 10
Aim: Aim

To achieve 60% of urine samples detecting blood + or greater to be repeated within a 3 week period. Guidelines would suggest that if microscopic haematuria is detected that two further samples should be submitted at 2-3 week intervals and if 2 or 3 are positive then referral should be considered.


Sinead McCourt - Postnatal Care Of Patients With Gestational Diabetes (2.6 MiB)
Upload Date: 10th December 2019 Downloads: 0
Aim: Aim

To improve the coding, recall and follow up of patients who have had a diagnosis of Gestational Diabetes By the end of May 2019 90% of patients will have had a HBA1C checked within the past year.


Ursula Conroy - Increasing Online Prescription Ordering (2.9 MiB)
Upload Date: 10th December 2019 Downloads: 10
Aim: Aim

• My aim was to increase the proportion of patients ordering repeat prescriptions online
by 100% in four months.
• I also had hope to promote online appointment booking but as most of our practice appointments are booked on the day only a small number of appointments were
available to book online.


Victoria Crooks - Management Of Pre Diabetes (2.3 MiB)
Upload Date: 10th December 2019 Downloads: 11
Aim: Aim

Based on NICE guidelines.

Ensure -
•Patients are coded as pre-diabetic
•Patients receive adequate counselling covering:
•An explanation of diagnosis
•How to reduce the likelihood of developing T2DM including information on:
•Diet
•Exercise
•Weight reduction
•Yearly monitoring of HbA1c


Zoe Devlin - Urine Samples� Improving The Clinical Information Available For The Interpretation Of Results (2.1 MiB)
Upload Date: 10th December 2019 Downloads: 0
Aim: Aim

All samples left must have a clinical information sheet completed otherwise samples
would not be tested

75% of MSSU should have the clinical indication documented in notes via patient
information sheet and urine template.

The documentation of patient symptoms should be done in the treatment room at
the time of testing, using the urine template created.