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Jack nagle2


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Primary Care in action
Case Studies

Published in: Health & Medicine, Technology
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Jack nagle2

  1. 1. <ul><li>Primary Care </li></ul><ul><li>in action </li></ul><ul><li>Case Studies </li></ul><ul><li>Dr Jack Nagle </li></ul><ul><li>CEO </li></ul><ul><li>ISO 9001 2008 </li></ul>
  2. 2. Need for Primary Care <ul><li>25% population - Chronic Disease </li></ul><ul><li>18 Chronic Diseases </li></ul><ul><ul><li>80% of hospital based expenditure; </li></ul></ul><ul><ul><li>10% for Diabetes alone </li></ul></ul><ul><li>366 patients on trolleys ( 07/11) </li></ul><ul><li>Best Practice: </li></ul><ul><ul><li>CDM </li></ul></ul><ul><ul><li>Primary Care – Canada, Australia, New Zealand </li></ul></ul><ul><ul><li>Better for the patient </li></ul></ul><ul><ul><li>Significantly reduce the cost of treatment, </li></ul></ul>ISO 9001 2008
  3. 3. Making it Happen ISO 9001 2008 PATIENTS ??? CDM
  4. 4. Case Study : Reducing A&E and Emergency Admissions <ul><li>Objectives: </li></ul><ul><ul><li>GatNet ( serving population ~ 250,000 patients NE England), </li></ul></ul><ul><ul><li>Improve continuity of care focused on best quality & best value health care, </li></ul></ul><ul><ul><li>Reduce increase in A&E activity </li></ul></ul><ul><li>Challenges: </li></ul><ul><ul><li>Patient Access </li></ul></ul><ul><ul><li>More efficient use of primary care resources </li></ul></ul>ISO 9001 2008
  5. 5. Case Study : Reducing A&E and Emergency Admissions <ul><li>Approach: </li></ul><ul><li>Commissioning Level: </li></ul><ul><ul><li>GatNet data gathering, </li></ul></ul><ul><ul><li>GatNet guidance on “LIS” – local incentive scheme, </li></ul></ul><ul><ul><li>Guidance generated for practices/health centres , </li></ul></ul><ul><li>Provider Level: </li></ul><ul><ul><li>Review of practice /centre patient admission rates </li></ul></ul><ul><ul><li>Identified avoidable admission episodes </li></ul></ul><ul><ul><li>Identified patient access issues </li></ul></ul><ul><ul><li>Practices signed up to incentivised LIS </li></ul></ul>ISO 9001 2008
  6. 6. Case Study : Reducing A&E and Emergency Admissions <ul><li>Approach ( Medical Centre, NE England – 15 GP Centre): </li></ul><ul><li>Access: </li></ul><ul><li>Patient survey – find what patients want & problems with access </li></ul><ul><ul><li>Continuity of care important, </li></ul></ul><ul><ul><li>Difficult to see preferred GP, </li></ul></ul><ul><ul><li>Patients double booking, </li></ul></ul><ul><ul><li>Complex system to see same day /urgent appointments </li></ul></ul><ul><li>Completed comprehensive clinical capacity analysis </li></ul><ul><ul><li>Re-defined appointments system </li></ul></ul><ul><ul><li>Better matching of “urgent” to routine appointment slots to needs – timing! </li></ul></ul><ul><ul><li>More streamlined for patients, </li></ul></ul><ul><ul><li>Eliminated need for patient call backs, </li></ul></ul><ul><ul><li>Introduced “dynamic” appointment system that responds to peak (urgent) day needs, </li></ul></ul>ISO 9001 2008
  7. 7. Case Study : Reducing A&E and Emergency Admissions <ul><li>Approach ( Medical Centre, NE England – 15 GP Centre): </li></ul><ul><li>Patients in Care Homes: </li></ul><ul><li>Identified as one of the main areas for avoidable admissions, </li></ul><ul><li>Optimise CDM of these patients </li></ul><ul><li>Increase medication review rates to optimise treatment control </li></ul><ul><li>Medication Review Protocol revised: </li></ul><ul><li>Diabetic Patient Care: </li></ul><ul><li>Complex patient pathway for diabetic care; </li></ul><ul><li>Access problems for patients, </li></ul><ul><li>Backlogs of waiting patients </li></ul>ISO 9001 2008
  8. 8. Case Study - Diabetes <ul><li>Pathway: </li></ul><ul><li>Identified access issues </li></ul><ul><li>Reviewed patient pathway </li></ul><ul><li>Set out review criteria </li></ul>ISO 9001 2008 Podiatrist Nurse Dietician GP Patient
  9. 9. Case Study - Diabetes <ul><li>Result: </li></ul><ul><li>New patient pathway defined </li></ul><ul><li>Improved Diabetic Clinical review </li></ul><ul><li>Increased Diabetic review capacity by 100% in 3 months, </li></ul><ul><li>Eliminated patient backlog </li></ul><ul><li>Leading to: </li></ul><ul><li>Improved patient care, </li></ul><ul><li>Clinically improved patient pathway </li></ul><ul><li>Patients seen in community environment </li></ul><ul><li>Better access </li></ul>ISO 9001 2008
  10. 10. Case Study : Reducing A&E and Emergency Admissions <ul><li>Why is it working: </li></ul><ul><ul><li>Availability of excellent patient pathway data, </li></ul></ul><ul><ul><li>Identification of very specific problem to address, </li></ul></ul><ul><ul><li>Incentive for practices to deliver, </li></ul></ul><ul><ul><li>Focused and measured initiative across large patient population, </li></ul></ul><ul><ul><li>Dynamic process ( measure, monitor and compare), </li></ul></ul><ul><ul><li>Multidisciplinary team reviews ( clinical & management) </li></ul></ul><ul><ul><li>Streamlined systems </li></ul></ul><ul><ul><li>Shared learning, </li></ul></ul>ISO 9001 2008
  11. 11. Alpha Primary Care Ltd <ul><li>Q & A </li></ul><ul><li>AHC at : </li></ul><ul><li>APC at : </li></ul>ISO 9001 2008