>>Dr Farzana Hussain: So this month, we’ve noticed an increase in the number of patients
that would like to register with us, this is partly due to one of our neighbouring practices
where the GP has recently retired, so the list has been dispersed and some of the patients
are coming our way.
The admin staff were spending two hours a day on new patient registrations, hoping to
register about 12 people in that time and this was having a negative impact on the other
tasks, such as the long term recall now that we are in March and coming to the end of the
QOF year, I really need the patients to be called so that myself and the doctors can
review the long term condition patients that are still outstanding.
We chose to use the Plan, Do, Study, Act cycle which I learnt about in the General Practice
Improvement Leaders Programme. I really liked this tool because it can test small cycles
of change to make improvement.
In the planning stage we had a whole team meeting to discuss how we could change the
registration process and admin felt that it would be easier if there wasn’t a restrictive
time for patients or for the admin staff, so on the appointment book we just put up
a whole days number of appointments and blocked out five minute slots and in those slots patients
could be booked in as and when they arrived. Those patients would then just have their
height and weight measured by the admin staff, and then the patient and the admin staff would
agree on a mutually convenient time as to when the rest of the registration would occur
on the telephone. We agreed that we would feedback weekly to see how this process was
working compared to our old process.
So in the ‘Do’ stage, we just decided to go for it and went operational for a week
and then we decided to study what our findings were after that first week. In the ‘Study’
stage, we realised that actually this was a really efficient system and that actually
the registration were being done at five minutes rather than 10 minutes and we had managed
to make a 50% saving on admin time. We wanted to make one tweak in that we found that the
15-24 year olds who were eligible for a urine chlamydia test were not coming in to pick
up the urine pot because it was a telephone consultation. So going forward we are going
to offer them the urine pot at the first initial face to face consultation where they have
their height and weight measured and we hope this really increases the chlamydia testing
in the practice.
So having managed to release five hours of admin time a week we are able to use this
time to help the GPs, locally we have many extending Primary Care services which are
similar to QOF and a new one has just come on board to improve our Cancer Care, so the
admin have managed to ring these patients in this new service so that the GPs can offer
face to face consultations for patients who have had a new cancer diagnosis within the
last six months, and this has improved Cancer Care and was a service that we were not offering
locally before.
There have been many benefits for the patients with the new registration system the first
one being that they only need to make one trip to the surgery. They’re also not restricted
to a certain registration time and that they can come any time they want between the hours
of 8am to 6:30pm.
Using the time that we’ve released for admin in the long term we would like to train one
of our admin members to become a medical assistant. We’re very excited to be part of the medical
assistant pilot locally. This will require mentoring from myself and training time, but
within a year we hope that we’ll be able to release GP time because at present each
GP gets 40 minutes a day to read the hospital letters and we’re hoping that we’ll able
to reduce that by 50% to only 20 minutes a day.
Slide narrative – This diary is the first in a series where Farzana will be sharing
her quality improvement journey. Please visit out YouTube channel to view future diaries.