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Training and Action for Patient Safety Red flags documentation in back pain

Training and Action for Patient Safety Red flags documentation in back pain. Dr Danielle Hann. What is TAPS. 20 week programme run by the Improvement Foundation Multi-disciplinary Aims to improve safety through ‘ action learning ’ Identify a local priority for patient safety

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Training and Action for Patient Safety Red flags documentation in back pain

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  1. Training and Action for Patient SafetyRed flags documentation in back pain Dr Danielle Hann

  2. What is TAPS • 20 week programme run by the Improvement Foundation • Multi-disciplinary • Aims to improve safety through ‘action learning’ • Identify a local priority for patient safety • Develop solutions • Implement solutions • Measure improvement

  3. Statement of Patient Safety Issue • Patient safety problem • There is a difference in GP perception and documentation of red flags in back pain • There is a problem because • There is a lack of consensus and we are not documenting the same thing. Some red flags could be missed and patients put at risk

  4. Measures for Improvement • What are we trying to achieve? • Improved GP knowledge of the red flags of back pain • better documentation, i.e 100% documentation of red flags • Outcome measures • Measure 1 • The number of patients presenting with back pain • Measure 2 • The percentage of patients with back pain that have red flags documented

  5. Actions • Weekly audit of notes to record the number of attendances with back pain and the percentage with red flags documented • Questionnaire of clinical staff • Educational event • Laminated red flag card in every room • Bar chart of individual doctors percentage (anonymous!) • Information sent round regarding accurate read codes

  6. Red Flags Answers from clinical staff Age of onset <20 or >50 9/10 History of trauma 5/10 Systemic illness/constitutional symptoms e.g. fever, chills, malaise, lethargy, weight loss 10/10 Immunosupression/steroid use 2/10 Neurological symptoms e.g. motor/sensory disturbance, disturbed gait, incontinence, saddle anaesthesia, reduced anal tone 10/10 Unrelenting pain 8/10 History of cancer 7/10 Questionnaire Results

  7. Number of patients presenting with back pain

  8. Basics of a run chart • There needs to be 10 points of data to establish a baseline • 8 data points either side of the base line indicates an effect • If there are 5 successive increases or decreases in the measures this also indicates change

  9. Percentage with red flags documented for each GP – May 10

  10. Percentage with red flags documented for each GP – July 10

  11. Limitations • Data is only as good as the coding • Sustainability • Changing peoples practice

  12. Conclusions • Increased percentage of red flags documented • Bar charts of individual results seem to be a powerful tool • Need to sustain the positive changes and improve them

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