Transcript iPM Breakout (1,051kb)

Lorenzo: A Clinicians
Perspective
Neil Nevitt
Podiatry Team Leader
Liverpool PCT
Who we are?
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Community Podiatry service
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Clinic based sessions
Home visits
Nail surgery
High risk patients – diabetes, PVD, RA
Biomechanics
Self referral system – open to all residents
of Liverpool
Currently- approx 500 clinic/ 180 dom
sessions a month
Areas for Improvement: Before
Lorenzo
• Accurate understanding of current patients vs total
caseload
• Improved booking and clinic management
• Waiting list management
• Scheduling system for home visits
• Choice
• Equity
• Improved accuracy of demographic details
As a Team Leader…
• Staff and rota
management
• Availability of Clinic
sessions
• Managing demand
• Understanding
productivity
• DNAs
• Identifying
opportunities
What the Podiatry Service
wanted to deliver?
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Flexibility and choice to patients
An accessible, equitable service for all
A service that responded to patient need
Team that understands its achievements is
run effectively.
• A service with fewer patient complaints
Reporting and Information
Gathering
Then
• Manual counts
• Monthly tallies
• Dependent on
individual clinic staff
Now
• Monthly reports
• Information Team
• Data quality
programme
• Citywide vs clinic
view
Liverpool PCT Podiatry Service Referrals
Month
Referrals
Jan-07
766
900
800
602
Mar-07
741
Apr-07
573
May-07
685
Jun-07
641
700
No of Referrals
Feb-07
600
500
400
300
200
100
Aug-07
Jul-07
Month
Jun-07
5096
May-07
Total
Apr-07
504
Mar-07
Aug-07
0
Feb-07
584
Jan-07
Jul-07
Liverpool PCT Podiatry Service Total Contacts
Month
Contacts
4500
Jan-07
3599
4000
3720
Mar-07
3825
Apr-07
3101
May-07
4058
Jun-07
4100
Jul-07
3782
3500
Number of Contacts
Feb-07
3000
2500
2000
1500
1000
500
0
Aug-07
Jul-07
Month
Jun-07
May-07
Apr-07
30109
Mar-07
Total
Feb-07
3924
Jan-07
Aug-07
Offering Choice and Managing Demand
Every little helps!
• Reviewing real time clinic managementknow what kind of day the team are
having- DNA’s, walk ins etc!
• Rota and clinic set up
• Letter production
Clinical Coding: Snomed CT
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North West Regional Podiatrist Dataset
Codes now available
Start to record clinical information
Diabetics, high risk, nail surgery,
orthotics
Liverpool PCT Podiatry Service
Recording Items for Podiatry Service on Lorenzo
Code
Term
Reason for Referral
Description
Snomed
Release
To be completed at initial appointment for patients with the following conditions only
CCRFR
Peripheral vascular disease
Patients with PVD
CCRFR
Peripheral Neuropathy
All patients with peripheral neuropathy
CCRFR
Connective tissue disease
Eg patients with rheumatoid arthritis
105969002
MR2
CCRFR
High risk diabetic
High risk following assessment
394672002
FLEM
CCRFR
Increased risk diabetic
Increased risk following assessment
CCRFR
Low risk diabetic
Low risk following assessment
394671009
FLEM
CCRFR
Foot Ulcer
Any foot ulcer
95345008
FLEM
Assessment codes
To be used to record assessments during initial & follow up appointments
CCASS
Diabetic foot risk assessment
For minimum assessments & annual review
394683006
FLEM
CCASS
Biomechanical assessment
Full/ simple biomechanical assessment
CC00030
FLEM
Treatment & Investigations
To be used to note treatment activity at each contact
CCTRE
Nail Care Procedure
Nails cut and filed
313026002
FLEM
CCTRE
Sharp debridement
Callus / corn removal with scalpel
CCTRE
Partial nail avulsion
PNA
20781004
FLEM
CCTRE
Total nail avulsion
TNA
183668008
FLEM
CCTRE
Wound care debridement
Debridement of ulcer
CCTRE
Wound care
Swab, dressing etc of wound
225358003
FLEM
CCTRE
Biomechanical therapeutic
activity
Manufacture and fitting of bespoke / adjusted orthotic device
& exercise advice
16361000000102
MR2
CCTRE
Provision of orthotic
Provision of simple insole or simple orthotic
Next Steps
• Sharing record with Dermatology
services
• Treatment room nurses
• Compare and share outcome measures
Summary
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Taken 2 years
Information Team supporting DQ
Just starting to code
Looking forward to Summary Record
Questions?
• Contact Details:
Neil Nevitt: 07795 370150
Claire Jones: 0151 234 5093