using it to reduce the stress of a diabetes clinic
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How can you reduce the stress of running a diabetic clinic - PowerPoint PPT Presentation


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Using IT To Reduce The Stress Of A Diabetes Clinic. What Happens at a Diabetes Clinic?. Screening for complications Identification of problems Intervention Prescribing Referral for advice. Why can diabetes clinics be difficult?. History Diabetes clinics are busy

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Presentation Transcript
what happens at a diabetes clinic
What Happens at a Diabetes Clinic?
  • Screening for complications
  • Identification of problems
  • Intervention
    • Prescribing
    • Referral for advice
why can diabetes clinics be difficult
Why can diabetes clinics be difficult?
  • History
    • Diabetes clinics are busy
  • Increasing numbers of patients
diabetes team
Diabetes Team
  • Nurses
    • clinic, nurse specialists, auxiliary
  • Dietician
  • Podiatrist
  • Phlebotomist
  • Laboratory staff
  • Secretarial and receptionist
  • Physicians
screening
Screening
  • Biochemical
      • Hba1c
      • Renal function
      • Lipids
      • Microalbuminuria
      • Thyroid?
  • Protocol
screening10
Screening
  • Retinal examination
  • VA
  • BP
  • Foot pulses and vibration perception
  • Protocol
potential problems
Potential problems
  • Missed screening
  • Duplicated screening
organisation
Organisation
  • Efficiency
it useful or useless
More work

Increased time

Useless information

Unfriendly screens

Information in but none out

Rubbish in rubbish out

Less work

Time saved

Useful information

Easy to use

Reports and audit

Sense checking

IT - Useful or useless?
slide14

LAB

SECRETARIES

DOCTOR (4)

FILE SERVER

NURSE

PODIATRIST

IT DEPT

slide15

Nurse

Lab

Doctor

IT Dept

Secretaries

Podiatrist

Dietician

Clinic summary

Podiatrist

GP

Lab

Dietician

Nurse

Doctor

useful
Useful
  • Quality
    • Transparent
  • Ordering bloods according to protocol
  • Download of biochemistry automatically
  • Reduced duplication if multiple users
  • Letter generation
    • Summaries
    • Addresses
    • Information for all
    • Drug and condition lists
slide18

Secretary prints blood requests

Patient arrives and booked in

Nurse

Specialist

Phlebotomy

Laboratory

HbA1c, cholesterol, U + E, Alb/creat ratio

Dietician

Nurse (VA, weight +/- eye drops)

Podiatrist

Physician (BP, feet, eyes)

Letter to GP

how do we judge our performance
How do we judge our performance?
  • Audit
    • Process
      • screening
    • Outcome
      • BP
      • Lipids
      • HbA1c
diagnosis chd risk of 30 2 year follow up
Diagnosis CHD Risk of > 30%2 Year Follow Up

Cardiovascular risk factors in

Those at the highest risk are

Being treated

  • 35.0%  25.4%

Calculated lowest possible risk

For this group = 22.0%

  • What is not at target?
diagnosis chd risk of 30 2 year follow up23
Diagnosis CHD Risk of > 30%2 Year Follow Up

Smoking status was unaffected despite advice issued at clinics

the future 1
The Future 1
  • Local
    • Link to eye photography
    • Link to primary care
      • Podiatry, GPs
    • Link to Lothian register
the future 2
The Future 2
  • Central funding and support for IT
    • Report by the Working Group on IT to Support Shared Care for Diabetes

*This is very important*

the future 3
The Future 3
  • Scottish Diabetes Survey
    • HDL (2000) 12
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