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Biomedical subjects

B Essex

Publications and source records attributed to B Essex.

5 recordsLinked to original sources
PubMed1991

Audit in general practice by a receptionist: a feasibility study.

OBJECTIVE: To examine whether audit can be done cost effectively by a practice's receptionist. DESIGN: The practice set goals for various aspects of care, and forms were devised for the receptionist to collect, analyse, and present data to assess whether these goals had been achieved in the previous year. SETTING: Six doctor practice in south London looking after 11,500 patients. MAIN OUTCOME MEASURES: Ability of receptionist to present data showing the level of attainment of the practice's goals; time spent on audit by receptionist each week. RESULTS: The practice set goals for immunisation; follow up of patients with abnormal cervical smears; frequency of recording of blood pressure and smoking habit; screening of patients over 75; care of diabetic patients and patients with serious mental illness; antenatal care; variations in workload; and availability of appointments. The receptionist was able to audit all these tasks in four hours a week; this increased her job satisfaction and extended her skills. A small amount of regular supervision was necessary--roughly 30 minutes a week in the first year of the study and 30 minutes a fortnight in the second--to ensure accuracy and deal with any difficulties that arose. CONCLUSION: The method developed enabled a receptionist to audit aspects of the practice cost effectively. There is great scope for enlarging the conventional role of the receptionist.

Cost-Benefit Analysis↗
PubMed1991

The psychiatric discharge summary: a tool for management and audit.

The aims of this study were to review the information needs of general practitioners in relation to the discharge of mentally ill patients; to design a discharge summary that would meet these needs and evaluate its use by junior hospital staff; and to assess the usefulness of this summary for audit. The information needs of general practitioners were identified from a review of the literature and from discussions with local general practitioners. A prototype discharge summary was designed and reviewed by a panel of general practitioners, regional advisors and course organizers from the south east Thames region. It was used for all patients discharged from the acute psychiatric ward in Hither Green Hospital over a 10 month period. One copy was given to the patient to take to the general practitioner, one was posted to the general practitioner and a final copy was kept in the patient's hospital records. The senior house officers found the summary easy to complete. It reduced uncertainty about what data to provide, and helped to focus on the most critical information needed by general practitioners for continuity of care. Using a pre-coded data collection sheet, analysis of the information on the summaries was easily done. It provided a rapid audit of caseload, diagnoses, therapy, methods of admission and discharge, length of stay, risk factors and roles of all involved in future management. This information can be of use to the psychiatric team, general practitioners and hospital managers and could be the first step towards the development of shared care.

Communication↗
PubMed1990

Pilot study of records of shared care for people with mental illnesses.

OBJECTIVE: To develop and evaluate a record of shared care to be held by the patient designed to increase the effectiveness of long term care of patients with severe mental illness. DESIGN: Questionnaires completed by medical staff, community psychiatric nurse, and patients to evaluate the shared care record. SETTING: General practices, a psychiatric outpatient clinic, and a mental health resource centre in south east London. PATIENTS: 84 Patients held shared care records over an 18 month period. They were selected by general practitioners, a psychiatrist, or a community psychiatric nurse, the criterion being that their care was shared between the general practitioner and the psychiatrist or community psychiatric nurse. Patients who had been admitted to hospital several times with short remissions were excluded. MAIN OUTCOME MEASURES: Patients were asked to complete a questionnaire to assess their views on the acceptability, usefulness, and problems of the shared care record. A questionnaire for health staff was designed to identify patients for whom the shared care record was most and least appropriate. It also assessed the patients' compliance and the way the record affected communication between all concerned. RESULTS: Patients found the shared care records very acceptable and were enthusiastic about their use. They valued being consulted about what was recorded and found the record of their treatment and progress useful. Patients also thought that they were in a better position to challenge their doctor. Those least likely to comply were people with severe paranoia. The acceptability of the record to patients greatly exceeded that to the psychiatrists and nurse managers, none of whom were interested in using the record. Communication among health staff was greatly improved by the shared care record, and it facilitated the identification of potentially dangerous drug interactions. CONCLUSIONS: Shared care records were acceptable to patients with severe mental illnesses, increased the patients' autonomy, and improved communication and the effectiveness of shared care. Obstacles to further development of this approach relate to the attitudes, perceptions, and anxieties of the doctors, nurses, and managers and can be overcome.

Attitude to Health↗