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The Map from a clinical perspective and how to engage Clinicians and embed the
Map into clinical workflow
Dr Amir HannanFull-time General Practitioner
Primary Care IT Lead, NHS North-West
Map of Medicine clinical lead, NHS North-West
Summary
• Why the Map of Medicine?
• What can it do for us?
• How can it help?
Why the Map of Medicine ?
“Medicine used to be simple, ineffective and relatively safe. Now it is complex, effective and potentially dangerous”
Sir Cyril Chantler, former Dean, Guy’s, King’s and St Thomas’ Medical and Dental School
The Report of the Public Inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984-1995
What can it do for us ?
NIDDM patient in 50s having a hypo 2.1. Feels unwell and lightheaded but not drowsy.
Needs advice NOW.
What do you do?
!
www.diabetes.org.uk
www.diabetes.org.uk
www.diabetes.org.uk
www.diabetes.org.uk
www.gpnotebook.co.uk
www.gpnotebook.co.uk
www.gpnotebook.co.uk
What does this have to do with Commisioning and Providing
services and Education? • Hard way vs the EASY way• BUT we need to gain confidence in the pathways….• AND understand this is the start of a journey and not
the end…• It SUPPORTS the discussions and possibly the need
for LOCALISATION• Gaining TRUST in this does not happen overnight or
after a talk - only after you unlock its secrets as I have shown do you begin to gain confidence
Use the patient as an “untapped resource” for Practice Based Commissioning
NHS Choices - www.nhs.uk - Health Guides available for the public
Map of Medicine
Health Guides
Map of Medicine
Health Guides
NHS Choices - www.nhs.uk - Health Guides available for the public
NHS Choices - www.nhs.uk - Health Guides available for the public
NHS Choices - www.nhs.uk - Health Guides available for the public
NHS Choices - www.nhs.uk - Health Guides available for the public
So why do I recommend the Map of Medicine
1. Easy to use2. Available NOW3. FREE for the whole of the NHS4. Up-to-date and accredited for supporting evidence-based delivery of care5. Can be localised for your needs6. Support and training available for all staff7. Opportunity to send instant feedback8. All future IT systems in the NHS will have this integrated as the preferred
knowledge management system for the NHS9. Patients can also access the Map of Medicine via www.nhs.uk10. Will support future referral pathways as multiple providers including the
private sector deliver services for NHS patients
So how do we engage clinicians and embed the map in clinical workflow ?
This is not going to be easy!
Think CLINICIANS and PATIENTS
(in a patient-led NHS)
Who ?• Different drivers for different people
– You will know what the best strategy is - this just gives certain considerations– High quality care– Special interest eg gynaecology, cardiovascular medicine or chronic disease groups such
as diabetes group, palliative care group– Local “community of interest” within an LHC eg consultant, GP, nurse, OOH clinician– Training sessions eg Target– Appraisers - PUNS and DENS– Trainers and trainees– Offer locum cover for a clinician that wants to come to an event during the day - champions
can be nurtured as well as innate ability!– Locums / salaried GPs and nurses / general invitation– Poorly performing clinicians– Non-medical prescribers / Nurse Practitioners / Chronic disease nurses / pharmacists and
other allied health professionals– Out of Hours clinicians (GPs and Extended Nurses)– Equitable Access clinics, other “new” surgeries– PBC groups
• Commissioning new services• Limiting costs by looking at referral patterns / prescribing
– Expert patients, Self Care groups, Patient Participation Groups, Outpatient clinics
Embedding in Workflow• Much more harder!
• Think WHY before HOW, WHAT and WHEN
• Diffusion of innovation
• Incentives / disincentives
• Appraisal folder
• “MoM” day with a gap analysis when fully staffed
• Share ideas / tips with each other within a clinical team
• Encourage Significant Event Analyses on user case scenarios (lessons learned when it went well as well as when it did not go as well)
We can make it EASIER if we identify the right people AND create the right environment for them to learn
KEEP IT SIMPLE!
Pictures taken from www.mediclicks.net
For further information please see
www.mapofmedicine.com
Or contact Ketan Patel, Implementation Manager,[email protected]