Re-audit Don’t just screen - intervene Paul Greenwood Project Manager.
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Transcript of Re-audit Don’t just screen - intervene Paul Greenwood Project Manager.
Re-auditDon’t just screen - intervene
Paul Greenwood
Project Manager
AuditNovember 2012 audit response = 543
May 2013 re-audit response = 524
Male – 67% Female – 33%
Total numbers within screening periods
4 weeks – 14
3 months – 47
12 months – 146
24 months - 295
Analysis - issues• Survey Monkey used and not paper copy.• Confusion over intervention refusal/referral
rates.• Handful of incomplete audits compared to
Nov audit.
Analysis• Data clearer• 63%- 80% received
complete screening package at each time period.
• 20-35% still not recorded screen when eligible.
• One site shows 100% improvement at 4 weeks/3 months.
• Lag in data for those not yet due screen.
• Family history had 7% N/A ?
• 25% referral for exercise/dietician up 1%
• 57% smokers (223 no responses)
• High refusal rates smoking 80%+
Case example• 31 yr old female.• 4 weeks – No recorded screening.• 3 months - No recorded screening.• 12 months – Full cardio metabolic screen recorded.• 24 months- Full cardio metabolic screen recorded• No family history.• Smoker• Referred for Hyperlipidemia• Referred for exercise/smoking cessation (refused both)
BMI
• %
4 weeks 3 months 12 months
24 months
0
10
20
30
40
50
60
Nov auditre-audit
Referral – exercise/dietician/smoking
exer
cise
refe
rral
re-a
udit
refu
sal
smok
ing re
ferra
l
re-a
udit
refu
sal
0102030405060708090
Nov auditRe-audit
Smoking status recorded
4 weeks 3 months 12 months 24 months0
10
20
30
40
50
60
70
recordednot recorded
Full screening package Nov Audit
4 weeks 3 months 12 months 24 months0
5
10
15
20
25
30
35
40
1 type2 screen3 screen4 screen5 screenfull screen
Full screening package Re-audit
4 weeks 3 months 12 months 24 months0
10
20
30
40
50
60
70
80
90
1 screen2 screen3 screen4 screen5 screenfull screen
Target• 50%(69%) of all service users who are
eligible for screening to have received full cardio metabolic screening package within 4 weeks- 3 month periods.
• 20%(63-80%) of all service users who are eligible for screening to have received full cardio metabolic screening package within 3 -12 and within the 24 month period
Screening recorded within 3 months from date of prescribing antipsychotic medication
Weight Height BMI Blood glucose
Blood lipids
BP0
10
20
30
40
50
60
Nov auditRe-audit
Screening recorded within 12-24 months from date of prescribing anti psychotic medication
Weight Height BMI Blood glucose
blood lipids
BP0
5
10
15
20
25
30
35
40
Nov auditRe-audit
Further analysis• Gender• Deprivation/postcode data• Ethnicity• Refusal rates – Pro-active practitioner low
refusal rates. Workforce attitude to physical health.
• Targeted approach to core group not screened
PDSA’s• Primary care – improving communications/ SMI
and non SMI registered.• Public health – Engaged with health
trainers/health improvement programme• IT – utilised outlook calender as flagging
system/screening checklists• Workforce- developed champions/skills training• Improved equipment
