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Quality improvement of prescribing safety: a pilot study in primary care using UK electronic health records.

Booth, HP; Gallagher, AM; Mullett, D; Carty, L; Padmanabhan, S; Myles, PR; Welburn, SJ; Hoghton, M; Rafi, I; Valentine, J (2019) Quality improvement of prescribing safety: a pilot study in primary care using UK electronic health records. Br J Gen Pract, 69 (686). e605-e611. ISSN 1478-5242 https://doi.org/10.3399/bjgp19X704597
SGUL Authors: Rafi, Imran

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Abstract

BACKGROUND: Quality improvement (QI) is a priority for general practice, and GPs are expected to participate in and provide evidence of QI activity. There is growing interest in harnessing the potential of electronic health records (EHR) to improve patient care by supporting practices to find cases that could benefit from a medicines review. AIM: To develop scalable and reproducible prescribing safety reports using patient-level EHR data. DESIGN AND SETTING: UK general practices that contribute de-identified patient data to the Clinical Practice Research Datalink (CPRD). METHOD: A scoping phase used stakeholder consultations to identify primary care QI needs and potential indicators. QI reports containing real data were sent to 12 pilot practices that used Vision GP software and had expressed interest. The scale-up phase involved automating production and distribution of reports to all contributing practices that used both Vision and EMIS software systems. Benchmarking reports with patient-level case review lists for two prescribing safety indicators were sent to 457 practices in December 2017 following the initial scale-up (Figure 2). RESULTS: Two indicators were selected from the Royal College of General Practitioners Patient Safety Toolkit following stakeholder consultations for the pilot phase involving 12 GP practices. Pilot phase interviews showed that reports were used to review individual patient care, implement wider QI actions in the practice, and for appraisal and revalidation. CONCLUSION: Electronic health record data can be used to provide standardised, reproducible reports that can be delivered at scale with minimal resource requirements. These can be used in a national QI initiative that impacts directly on patient care.

Item Type: Article
Additional Information: © British Journal of General Practice 2019 This article is Open Access: CC BY-NC 4.0 licence (https://creativecommons.org/licenses/by-nc/4.0/).
Keywords: electronic health records, general practice, primary care databases, quality improvement, Anti-Inflammatory Agents, Non-Steroidal, Drug Utilization Review, Electronic Health Records, General Practice, Heart Failure, Humans, Patient Safety, Pilot Projects, Primary Health Care, Quality Improvement, Risk Assessment, Thiazolidinediones, United Kingdom, Humans, Thiazolidinediones, Anti-Inflammatory Agents, Non-Steroidal, Risk Assessment, Pilot Projects, Drug Utilization Review, Primary Health Care, Heart Failure, Electronic Health Records, General Practice, Quality Improvement, Patient Safety, United Kingdom, electronic health records, general practice, primary care databases, quality improvement, 1117 Public Health and Health Services, Public Health
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Clinical Education (INMECE )
Journal or Publication Title: Br J Gen Pract
ISSN: 1478-5242
Language: eng
Dates:
DateEvent
September 2019Published
29 August 2019Published Online
21 February 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial 4.0
PubMed ID: 31262845
Web of Science ID: WOS:000483925100003
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113041
Publisher's version: https://doi.org/10.3399/bjgp19X704597

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