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PDSAs are the way to go |
by Sandi Hill
“If you keep doing what you’re doing you’ll keep getting what you get.” This was the catch cry of the Wave 1 practices that took up the challenge of daring to try something new, and as a result have created sustainable and meaningful changes to the ways they practice primary health care.
Focus
Their focus on improving practice systems, data management and patient care in relation to better access and informed, proactive, patient self management in the care of patients with diabetes and coronary heart disease gave them something to aim for.
Direction
The change principles provided by the expert reference panels gave them direction (sign posts) and the collaborative process of promoting team work and sharing of ideas at a local and national level inspired them to work towards a common goal.
Measurement
Measuring and tracking the impact of the changes through monthly measurement and recording provided the impetus to keep going. They recognised that knowledge is power.
PDSA
They also proved beyond doubt that the quality improvement tool of Plan, Do, Study and Act (PDSA) is the way to go forward. During the first eight months of the program, the eight Northern Rivers practices in Wave 1 undertook 189 PDSAs.
The eight practices in Wave 2 whose representatives attended the first of three learning workshops in Melbourne in December 2005 have embraced the Collaboratives with equal enthusiasm.
PDSAs as a quality improvement tool are not the exclusive domain of the Collaboratives and can be applied to any small change you wish to test. For more information I recommend visiting the National Primary Care Collaboratives website www.npcc.com.au. This site provides clear user friendly guidelines for anyone wanting to know more about the method.
Not for you?
You may think, as some people do:
- We’re too busy to consider making changes.
- We don’t have time.
- It wouldn’t work here.
- It would take too long.
Wrong!
PDSAs are small incremental steps, not long term projects. They should be doable within a few days or weeks.
Example
Establish a system for creating, validating & updating a register of people with CHD.
PDSA – Description
Establish the register of patients with CHD and identify coding issues
Plan: On Monday the 12th Dec, the practice nurse and GP will search patients on aspirins, ACE inhibitors and patients with IHD and related diagnosis. GPs to go through lists mark/tick against patient’s names to confirm diagnosis and medicines or to inactivate patients due to ‘no longer visiting practice’ or ‘deceased’. Re-run updated lists.
Do: Practice nurse and GPs carried out searches using data tool and MD search function.
Study: 10 patients were found who were taking ACE inhibitors but who were not diagnosed with CHD.
Act: PN will create a protocol for doctors to ensure that all patients on ACE inhibitors will be coded with CHD.
Sandi Hill is the division’s Collaboratives program manager.
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