#GPFUQ 146 How
do you get big projects started and finished?
This is the how do you herd cats
question. First recognise and work on all the different elements; the political
dimension, the personal dimension, human behaviour, organisational behaviour,
other interests, motivations and blockers, the time and timing. Second make a
start (it’s the essential first step), work at it (it won’t happen by
accident), accept steady progress (it will take time to deliver), try to create
independent brokerage (avoid any conflicts of interests), recognise any vested
interests (pander to them when necessary), encourage friendship (like each
other and be happy), bring dissenters inside the tent (use their ideas and
energy), deal with key stakeholders individually (formally and informally and
be flexible with your approach), be trustworthy, honest and open (but leave
some room for secret manoeuvres).
#GPFUQ 147 What’s the secret of life?
Honesty and fair dealing. If you can fake that, you've got it made. Groucho Marx
#GPFUQ 148 Why
do GPs
use IT like its ‘paper under glass’?
Practices have been paperless
for years but often they use the new
technology to work in the old ways - the ‘paper
under glass’ mistake. Practices fail to use IT to its full extent.
Some suggestions for action
·
Ensure consistent use of practice
computer system by the practice team. This does require training and expense -
but makes notes much more useable
·
Have regular sessions to share ‘top
tips’ on how to use IT in the practice.
·
Find out and use all the shortcuts
like macros on your computer system
·
Stop duplication of any work that’s
on paper and computer
·
Have all the forms and letters you use
formatted as mail merge so they are automatically filled by the computer
·
Build synchronized actionable alerts
(i.e. they routinely prompt at the right time what’s needed for good long term
care) in the EHR, and train the team exactly when to act on them in their daily
routine.
·
Make sure that when you design
something it fails safely. For instance don't send out emails saying "get
back to me if there is a problem on this"
·
Gets patients to enter more
information in the EHR - home BP, Glucoses, questionnaires
·
Use non-clinical portions of EHR
templates to record other important information e.g. contact details for next
of kin, key worker for mental health patients so that any clinician can find
this information easily
·
Use internet technology that
facilitates new ways of communication mechanisms e.g email consultations with
patients, use web cam link from patients home to surgery, videoconferencing,
facebook, twitter, shared documents etc
·
Automate data extracts and
collection – e.g. on referrals, workload. Data drives improvement.
·
Use e-mail to ask clinical questions
and to liaise with and get support from secondary care
·
Use email distribution lists, always
use a subscribe and unsubscribe option
·
Use Youtube to spread learning e.g.
instructions for patients on self management
·
Avoid looking at the screen instead
of looking at the person - this is a false economy in terms of time, people
need to feel listened to
·
Use Voice recognition software
instead of typing to enter clinical notes and write letters
·
Get joined up with the other
relevant health and social care IT systems. Liaise with third parties like
Hospital Trusts to ensure GPs can access hospital IT systems from their desktop
PC. E.g. access pathology reports
·
Insist on having ‘single signs on’
to access the various other systems you need to use on your computer. Single
signs on will increase their use.
·
Integrate referral pathways from
third sector partners
·
Use decision support tools that help
you provide informed consent e.g. What are the numbers needed to treat for the
intervention you are recommending
·
Make sure information does not need
to be entered more than once
·
Allow patients access to a copy of
their personal health record and gets them to check that its correct
