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manual:workflows_clinicmanagement

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Clinic Management

This process may be useful for clinics using MMEx and a model of care similar to the IUIH Model of Care. The focus of this workflow is on ensuring data quality and promoting proactive health care.

Acknowledgement of IUIH

We would like to thank the Institute of Urban Indigenous Health (Queensland) for sharing their clinic workflows which are the framework for these workflow pages.
These workflows are intended as a guide only, to show how you might use MMEx to efficiently manage patients and workload.

Key Maintenance Measures

Clinic managers need to ensure the following Key maintenance Measures are regularly performed.

Standardise Patient registration

On a daily basis, ensure all patients are correctly registered in MMEx with:

  • Name (& aliases),
  • DOB,
  • ATSI status,
  • gender,
  • current medicare number & expiry,
  • contact address & numbers.

The first 3 are essential for automatic assignment of Lifetime care plan; Medicare number and expiry date are essential for billing to be processed.

Check incoming Pathology Results

Twice a week: Check all incoming pathology results and ensure results are appropriately assigned and followed up

  • Assign unmatched results.
  • Ensure each GP is following up own results
  • Ensure regular / senior GP also checks results for GPs who have left
  • Ensure GP’s understand that all actions when reviewing path results/reports (except no action) create a task for patient (in To Do list), which they or other staff need to respond to.
  • Check results for visiting GPs and ensure they are your clinic’s patients before allocation.

Review task List

On a Daily basis:

  • Review for follow up tasks, coordinate health team response & help prioritise / direct effort.
  • Ensure attempts to contact are captured, tasks are completed then archived once done.
  • Liaise with requesting GP if patient untraceable / not responding to decide course of action.
  • Ensure tasks scheduled are for one off / short term review only. Tasks should not be used to schedule future care normally prompted through care plan assignment e.g. chronic diseases, abnormal pap smear, FTT / child at risk monitoring, immunisation, INR etc.

Control user Access

On a weekly basis or as required:

  • Create/request new user set up as needed.
  • Request access for visiting Specialists/Allied health workers (via their specialist/allied health location in MMEx).
  • Control access for other visiting staff as needed.
  • Promptly disable staff who have left/are no longer providing visiting service

Periodic Database Cleaning

Every 1-3 months: User patient reporting for periodic population / database cleaning

  • Involve staff with local knowledge and appropriate skills
  • Perform searches and correct/update population information
  • When duplicate clients found – refer details to Practice Manager.

Support for New Users

As new users begin work:

  • Check their role and permissions are correct and that they have completed their MMEx profile.
  • Ensure relevant provider, prescriber and immuniser numbers are recorded correctly
  • Ensure medication PIN is set if required by organisation practices.
  • Ensure orientation of MMEx basics (utilise your SuperUser) specific to their role and how what they do affects the work of others (tasks, care plan assignment, team work, opportunistic work/adding value to client contact)
  • Encourage local computer knowledge sharing and support between staff.
  • Liaise with internal MMEx support staff and provide contact details to new staff.

Provide easy access to plan for what to do when / if internet connection is lost

  • Ensure plan is in an obvious place & accessible to all staff.
  • Liaise with your IT and support staff as needed.

Regular discussions

At each Meeting with Clinic Staff:

  • Make a brief MMEx discussion a regular feature of staff meetings/CQI meetings
  • Ensure that any problems are reported, and ask for updates if there does not seem to be any progress.
  • Periodically provide formal feedback with/to staff on client numbers/access, MBS income and items, chronic disease care, other clinical feedback

Maintain Local System security

Ensure staff:

  • only use their MMEx account
  • log off when not using the system
  • empty local downloads folder daily

Manage Organisation Account

Periodically check or push email notification of messages sent to Organisational account inbox

Suggested regular MMEx Searches

These searches are usually undertaken through Patient reporting. However you may use:

  • Care Plans
  • Care Plan Activities
  • Antenatal Register Report
  • Patient Report

or any of the available reports to assist you.

Demographic Searches

Weekly:

Search for one variable at a time and update - missing gender, DOB, ethnicity, medicare number.

Monthly:

  • Search for inactive/alive patients and consider if this is correct.

Staff sometimes use this inappropriately eg changing the status of duplicate file instead of organising for it to be merged. Incorrectly labelled patients can be adjusted – consider active status, update suburb/community & changing PHC provider to false.

  • Search for duplicate clients and manage.
  • Search for clients with no primary provider

3 Monthly:

  • Search for clients listed as casual who have a local address, consider if this status appropriate, and edit as required.

Clinical Searches

Use Clinical searches to improve:

  • Quality of Care to clients and
  • Quality of Data.

Tasks:

Regularly perform search of overdue Tasks to keep an eye on list and how team are coping with it (Keeping up with requests, advising of attempts and completion of task.). Use filters to sort Tasks.

  • Keep list to a manageable length.
  • Discuss issues with staff.

General Care Plans:

On a monthly basis:

  • Search for clients with abnormal results, but ‘no matching/correspnding’ care plan.

Discuss who is best placed to undertake this process with GP (and other staff that may be authorised to assign care plans e.g. Women’s Health Coordinator.

  • Unordered List ItemRegular comparisons should be made for all care plans which are driven by abnormal pathology e.g. Anaemia, diabetes, hypertension, 5 stages of kidney disease, dyslipidaemia, abnormal pap smears, SH Risk & STI care plans, Thyroid disease, etc.

This task entails reviewing the client care plan list and editing as needed (e.g. if CKD has progressed, archive old proteinuria care plan and assign the relevant CKD stage).

  • Assign new care plans in line with criteria. When criteria are not met, schedule a follow up in Tasks for the client.

Antenatal care Plans

On a monthly basis, search for:

  • >42 weeks without outcome updated (in ‘Patients’ search). Update outcome detail and archive care plan.
  • Women with ante natal care plan overdue 6 week post natal check by 1 month

Population Health Care Plans

Care plan searches are normally used to organise follow-up activities for population health programs also improve data quality and client care.

Manager may include these searches to consider opportunistic care delivery and program delivery. This is especially important when program staff need this support.

Search for clients with:

  • Diabetes & HbA1c overdue by 3 months
  • Hypertension & BP overdue by 3 months
  • CAD or Heart Failure or Other Chronic Heart Disease overdue BP by 1 month
  • Dyslipidaemia & Lipids overdue by 3 months
  • Proteinuria Early ovderdue ACR by 3 months
  • Proteinuria Advanced overdue eGFR by 3 months
  • CKD 3 or CKD 4 & overdue eGFR by 1 month
  • HSIL pap smear & overdue colposcopy by 1 month
  • LSIL pap smear (including recurrent) & overdue pap smear by 1 month
  • SH Risk & overdue NAT PCR by 1 month
  • Syphilis Contact & overdue Trep.serol by 1 month
  • Warfarin & INR overdue 1 month
  • FTT & overdue weight 1 month
  • At Risk Child overdue weight 1 month
  • Implanon & overdue 1 month
  • Medroxyprogesterone & overdue 1 month
  • IUD & overdue 3 months
  • 715 in progress and target them for completion
  • GPMP/TCA and Reviews in progress and not completed

CQI Searches

1.1 The number AND proportion of regular client population of service area who ARE Aboriginal and Torres Strait Islander BY gender (This becomes the Denominator - Total number of ATSI Regular clients - for other searches) MMEx Search Parameters: Numerator: Number of patients who have an Indigenous status recorded in their record.

  • Patient gender: Male, Female, Unknown
  • ATSI status: Aboriginal, TSI, ATSI
  • Patient activity: Active
  • Patient provider status: Active (Tracking Based) (At Least 3 visits in the last 24 months)

Denominator: Total number of Regular clients.

2.1 The number AND proportion of regular Aboriginal and Torres Strait Islander clients aged 15-54 years who are up to date with an Adult Health Check - 715 (completed within the last 12 months)BY gender MMEx Search Parameters: Numerator:

  • Patient gender: Male, Female
  • ATSI status: Aboriginal, TSI, ATSI
  • Patient activity: Active
  • Patient provider status: Active (Tracking Based) (At Least 3 visits in the last 24 months)
  • Patient matches the following care plan activities:
    • Care plan: Any
    • Activity: Adult Health Check (Item 715);
    • already completed between (12 months date period)

Denominator:

  • Total Number ATSI clients aged 15-54 years
  • Patient gender: Male, Female
  • ATSI status: Aboriginal, TSI, ATSI
  • Patient activity: Active
  • Patient provider status: Active (Tracking Based) (At Least 3 visits in the last 24 months)
  • Age: Within 15 and 54 years
manual/workflows_clinicmanagement.txt · Last modified: 2019/06/30 23:39 by sarahb