Improving access to the KIS in secondary care

Area of Science:

• Healthcare Informatics
• Patient Care Management
• Quality Improvement in Medicine

Background:

• Effective communication of anticipatory care planning (ACP) discussions between patients and general practitioners is crucial across healthcare settings.
• The Key Information Summary (KIS) is a software tool in Scotland enabling electronic sharing of primary care data, including ACP details, within the NHS.
• KIS is accessible in secondary care via hospital electronic records in abbreviated and full versions.

Purpose of the Study:

• To significantly enhance clinician access to the full Key Information Summary (KIS) record within secondary care settings.
• To evaluate the impact of quality improvement interventions on KIS accessibility and utilization.

Main Methods:

• Four Plan-Do-Study-Act (PDSA) cycles were implemented between October 2014 and March 2016.
• Interventions focused on improving access to the full KIS within a hospital Medical Admissions Unit.
• Data were collected at baseline and after PDSA cycles to measure changes in KIS access and clinician awareness.

Main Results:

• Baseline data indicated low awareness (most clinicians unaware) and utilization (19% saw KIS) of available KIS information.
• Where KIS was accessed, clinicians found it useful (75%) and noted its potential to alter clinical management (20%).
• Following three PDSA cycles, full KIS access increased from 4% to 45% within 5 months, but this improvement was not sustained one year later after a fourth cycle.

Conclusions:

• Quality improvement approaches can significantly improve access to the full KIS at hospital admission.
• Enhanced access to KIS has the potential to influence clinical management decisions for specific patients.
• Sustainable, system-wide strategies are essential for maintaining improvements in KIS accessibility and utilization long-term.