Below are a few examples of the wide variety of Quality Improvement activities that have been carried out in practices around the region. If you would like to showcase your Quality Improvement activity, please email qi@westvicphn.com.au
Alcohol status
A Geelong based clinic carried out an audit of their patient data, which indicated the alcohol status of patients is below the target of 75% with records indicating they were at 67.3%. They used their patient data extraction tool to generate lists of patients for each GP who are aged 17+ and do not have an alcohol status recorded have been generated. The lists were provided to the GPs to audit their own patient base. The clinical audit tool was used again to audit the status of this indicator one month later.
The alcohol status was discussed at a clinical meeting and then reviewed, immediate improvements were recorded. There were improvements for all GPs recording the alcohol status with the biggest improvement being 10.5%. Following the initial QI activity, the clinic continued to report the status in the following months and improvements continued. Current indicators are now over 76%. An overall improvement of 2.1% was recorded. Some members of the clinical team noted the list was useful to bring the recording of status into focus.
From the Practice Manager: “the QI activity highlighted the need for focus, continuing to report in the following months established habitual reviews by the clinic team – improving the quality of patient records”.
Excessive consumption of alcohol is a preventable risk factor for many chronic conditions such as cardiovascular disease and so it is important to identify which patients may require additional support to reduce alcohol consumption.
Cervical screening
This quality Improvement (QI) activity was of special interest to practice nurses working at a medical clinic on the Surfcoast who wanted to make it easier for women who may have found the change from getting screened every two to five years confusing. The nurses found that people were avoiding cervical screening due to COVID and many women became overdue for screening. Their goal was to increase the number of women screened for cervical cancer.
By looking through their clinical patient data, they identified 78 overdue patients over a four-year period. Four patients had moved out of the area, four declined getting screened, five no longer required screening due to age.
As a result of calling patients, 16 booked and were screened in March and April. This means, if any of the patients have precancerous abnormalities, these will be detected and treated, which is necessary for achieving the overall aim of reducing incidence and mortality from cervical cancer.
Shingles vaccination
Practice Nurses at a Western Victoria medical clinic used Commonwealth funding for Zostavax to 71–79-year olds as an opportunity to undertake a Quality Improvement activity.
They aimed to reduce the risk of shingles and related complications which increase with age. The goal was to increase the number of patients immunised against shingles by 10% over a 1-month period, using their clinical extraction tool to monitor the numbers.
One of the nurses identified eligible patients and offered them an appointment with GP/Nurses to assess their suitability for the Zostavax. They put together a QI team that included GPs, nurses and administration and their WVPHN Practice Facilitator and used messaging to raise awareness amongst staff in addition to posters and brochures to promote immunisation in the practice. They found that more patients were asking their GP or nurse about getting the vaccination after seeing a poster or brochure in the waiting room. There was a 10.3% increase in patients getting the Zostavax over a two month period which means that more patients in the area are now protected against Shingles and will not experience the painful rash and blisters associated with the viral infection.