Name: Jane Smith test
Job Role GP sessional
Federation Area: Lisburn
Contact Email: firstname.lastname@example.org
Project Title: TEST Reducing DNA rate for diabetic clinics
1. WHAT WAS THE PROBLEM YOU WERE LOOKING AT?
A small but concerning number of patients DNA their diabetic clinic appointments. These patients tend to have more complications and so it is essential that we encourage them to attend. Those that DNA once are very likely to DNA recurrently. The diabetic clinic is run by both the practice nurse and a GP who know this group of patient well. There is one receptionist who co-ordinates the booking of appointments and communication with patients.
2. WHAT WAS YOUR PROJECT AIM? WHY DID YOU CHOOSE THIS PROBLEM?
Our practice has an increasing number of patients with type 2 diabetes. There is a recall system in place for the Diabetic clinic which runs every 2 weeks. There are more patients needing seen than their are clinic slots so it is of great concern when DNAs occur. The aim was to reduce the number of DNAs by 50% over 6 months
3. WHAT QUALITY IMPROVEMENT METHODS DID YOU USE?
The practice team (GP, practice nurse, practice manager, receptionist) created a process map to understand what happenned from a patient is identified as needing a clinic appointment through to their attendance on the day. A PDSA cycle was created
4. HOW DID YOU MEASURE THE EFFECTS OF YOUR CHANGE?
A run chart kept track of the number of DNAs at each clinic over a 6 month period. A record was also made of the names of those DNAs to determine if it was specific people.
5. WHAT WENT WELL?
The patients received a text reminder 24 hours before their appointment and patients confirmed this was useful. For patients who DNA, they were phoned by the GP or practice nurse to ask why and offered an appointment at alternative time if appropriate. There were less DNAS noted and so more patients were seen in a timely manner
6. WHAT DIDN’T GO WELL?
it was frustrating that a small numebr of patients contineu to DNA despite a range of methods being used to encourage attendance. Elderly patients do not all find text messaging useful and so it might be best to ring these pateints the day before the clinic
7. WHAT DIDN’T GO WELL OR YOU WOULD DO DIFFERENTLY?
To consider sending additional leaflet from Diabetes UK out with each clinic invite explaining what happens at the appointment to provide reassurance for those that are anxious or concerned