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3rd April 2001 Birmingham - PowerPoint PPT Presentation


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MIQUEST Unravelling the Mysteries. MIQUEST Unravelling the Mysteries. Lynne Wright PRIMIS Information Manager Dr Andrew Perry MIQUEST Consultant Sue Trinder Clinical Audit Facilitator, Oxfordshire MAAG. Outline. Introduction Setting the scene: Sue Trinder

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Miquest unravelling the mysteries l.jpg
MIQUEST Unravelling the Mysteries


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MIQUEST Unravelling the Mysteries

Lynne Wright

PRIMIS Information Manager

Dr Andrew Perry

MIQUEST Consultant

Sue Trinder

Clinical Audit Facilitator, Oxfordshire MAAG


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Outline

  • Introduction

  • Setting the scene: Sue Trinder

  • Preparing to write queries: Andrew Perry

  • Feedback software: Lynne Wright

  • Practice feedback: Sue Trinder

  • Questions


Setting the scene l.jpg

Setting the Scene

Sue Trinder

Clinical Audit Facilitator, Oxfordshire MAAG


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Why a CHD Audit

  • National Service Framework for CHD

  • MAAG priority

  • Each of the 6 PCGs had made CHD a priority for their clinical governance agenda

  • An annual MAAG audit

  • CHD SQA and Health Promotion requirements are satisfied by participation in MAAG audits


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CHD AuditFrom the Beginning

  • Agree the team

  • Find the Evidence

  • Agree the audit criteria

  • Decide which Read codes to use

  • Write the queries

  • Put queries through Query Manager

  • Send out to the 62/88 Oxfordshire practices with MIQUEST software installed


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CHD Audit – Next Time!

  • We intend to consult far more widely about:

    • Clinical criteria

    • Read codes used

    • Format of feedback

  • We will document our decisions and give clearly written and precisely described instructions to Query writers

  • We will be careful to avoid making assumptions


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MIQUEST Unravelling the mysteries

  • What can and cannot be done with MIQUEST

    • Can do almost everything we ask of it in terms of collecting clinical data

    • Cannot tell us how or what to ask

  • Planning, consulting, checking and then checking again absolutely vital


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Setting the Scene

Sue Trinder

Clinical Audit Facilitator, Oxfordshire MAAG


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Preparing to Write Queries

Dr Andrew Perry

MIQUEST Consultant to PRIMIS

Clinical Information Consultancy


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Writing MIQUEST queries

It’s really not difficult…

… it’s just the software…

…. that’s confounding


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All you need

  • Wonder woman

  • Super hero

  • Team work


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All you need

  • Knowledge of clinical systems

  • Audit experience

  • Read code knowledge

  • Medical backup


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Process

  • Specify requirements

  • Create query definitions

  • Write queries



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Specify requirements

  • Iterative process

  • Start with existing audit

  • Reduce to set of questions

    • How many patients have …?

    • Of these how many also have …?

    • Do they have a record of …?

    • When was the last …?

    • How many have a raised …?

  • Specify the Read codes

  • Consultation



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Specify the Read codes

  • Initial specification

    • Start from PRIMIS query sets

  • Clinical consensus

    • Different ways to code conditions

    • Different systems

    • PRIMIS Clinical Advisory Group


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Specify the Read codes

  • Need codes for each

    • diagnosis

    • treatment

    • medication

  • Require codes for

    • each version of Read codes

    • any local or system specific codes


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Create query definitions

  • Identify the subsets required

  • Query for each type of data

  • Specify selection criteria

  • Decide on output and therefore style

    • Subset

    • Analyse

    • Report

  • Specify the output


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Styles of HQL query

  • SUBSET

    • Selects a sub-population for future analysis or reporting

  • ANALYSE

    • Counts patients or records meeting selection criteria

    • Can count in bands (e.g. by Age, Sex)

  • REPORT

    • Extracts selected data about patients in a sub-population

    • Allows more detailed subsequent analysis


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Writing queries

  • Create new set for each disease area

  • New query for each

    • Subset

    • Condition

  • Add selection criteria as specified

  • Add the output

  • Quality assurance and piloting


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Feedback Software

Lynne Wright

PRIMIS Information Manager



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Structure

  • Rush Import directory on local hard drive

    • Containing:

      • RushImport ini file

      • Response import ini file

  • Rush template in the template directory of Microsoft office

  • Directory of aggregated responses


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Aggregated Responses

  • Using Response Manager

  • Select responses to aggregate

  • Select Rush layout

  • Click the aggregate button




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Two Control (ini) files

  • ‘RushImport’

    • Controls the import directory

  • ‘Response import’

    • Lists all responses to be imported

    • Order of the responses

    • Title of the responses to be shown both on the sheet tab and in the sheet heading



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Preparing a Rush Spreadsheet

  • Aggregated analyse responses in Rush format

  • Control (ini) files for import

  • Rush import sheet

  • Rush Excel template


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Rush Excel Template

  • Using the Import data button to select:

    • Control (ini) file

    • Response directory

  • Check the response files

  • Import the response files






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Feedback Software

Lynne Wright

PRIMIS Information Manager


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CHD Audit Feedback

Sue Trinder

Clinical Audit Facilitator, Oxfordshire MAAG


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Individual Practice Feedback

  • Individual practice report

    • Crude and age/sex standardised prevalence

    • All audit criteria reported on

    • List of patients with operation codes without diagnosis codes given

    • List of patients with either monitoring or relevant drug codes without a diagnosis code given

  • Aim to improve CHD registers


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Individual Practice Feedback

  • Practice-based 2-hour workshop offered to all practices built around their audit results

    • Part of each workshop looks at data management issues within the practice

      • The use of recommended Read codes

      • Computer templates

      • Protocols

  • Training needs identified and training arranged

    • Read Code training

    • Creating templates

    • Use of clinical system search engine


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Comparative Feedback

  • PCG report

    • Anonymised data compared at PCG and county level

  • PCG clinical governance CHD workshops held

    • CHD NSF implementation plans agreed

    • Training needs identified

      • Practice nurse / GP 20-hour CHD workshops arranged

  • One PCG funded clinical system training


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CHD Audit Feedback –Next Time

  • Include a list of all of the codes used in each query in the practice reports

  • 2-hour workshops – huge time commitment

    • Include clinical governance leads?

    • Commission specialists?

  • Would like to have the Rush software available for MAAG use


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Discussion Session

  • MIQUEST

    • software questions?

    • query questions?

    • Rush questions?


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