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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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A template approach to quality improvement activity: a primary care example.

Christopher Fawcett1, Helen Moriarty, Roshan Perera

  • 1Horowhenua Community Practice, 62 Liverpool Street, PO Box 50, Levin 5540, New Zealand. Email:

Australian Health Review : a Publication of the Australian Hospital Association
|June 29, 2013
PubMed
Summary

A Quality Framework and Implementation Template improve opiate prescribing for chronic non-malignant pain (CNMP). This systematic approach aids smaller practices in enhancing patient safety and health service quality.

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Area of Science:

  • Health Services Research
  • Medical Quality Improvement
  • Pain Management

Background:

  • Escalating prescription opiate use for chronic non-malignant pain (CNMP) presents national and international health concerns.
  • Opiate prescribing impacts personal health, public health, and patient safety.
  • There is a need for improved quality and safety in opiate prescribing practices.

Purpose of the Study:

  • To demonstrate the utility of a Quality Framework and Implementation Template for reviewing opiate prescribing processes.
  • To illustrate the application of a Quality Framework for self-directed quality improvement in smaller medical practices.
  • To provide a worked example of opiate prescribing for CNMP to guide quality improvement initiatives.

Main Methods:

  • An Implementation Template, derived from a Quality Framework, was utilized.
  • The template consisted of focused questions to guide a quality improvement activity.
  • The approach was applied to opiate prescribing for CNMP within a clinical practice setting.

Main Results:

  • The practice team gained a better understanding of current prescribing systems and processes.
  • Actual and potential problems in opiate prescribing were identified.
  • Possible solutions and interventions for change were determined.

Conclusions:

  • The template approach is highly applicable to smaller specialist or community health service settings.
  • It enables health services to systematically focus on their own quality improvement activities.
  • This method facilitates addressing practice-specific topics of importance in a productive manner.