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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

Miquest unravelling the mysteries3 l.jpg

MIQUEST Unravelling the Mysteries

Lynne Wright

PRIMIS Information Manager

Dr Andrew Perry

MIQUEST Consultant

Sue Trinder

Clinical Audit Facilitator, Oxfordshire MAAG

Outline l.jpg

  • 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

Process l.jpg

  • 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


    • Selects a sub-population for future analysis or reporting


    • Counts patients or records meeting selection criteria

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


    • 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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  • 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


    • software questions?

    • query questions?

    • Rush questions?