Respiratory : Quality prescribing strategy - a guide for improvement
If we want different outcomes, we need to understand the system - the processes, people and how they interact with each other. This is important in identifying where you need to focus your improvement work.
Suggested actions - understanding systems
Health boards
- Is this a clinical priority for the health board? If not, why not?
- Does the board have an identified clinical lead for this?
Managed Clinical Network (MCN) and Respiratory Specialists in secondary care
- Are the MCN and respiratory specialists aware of the guidelines and ready to lead by example in implementing these?
- Does the MCN link with local groups of people with respiratory conditions and can these be developed locally?
Clusters and Cluster Quality Leads (CQLs)
- Have the CQLs and clusters reviewed the recently published cluster reports?
- Are the clusters willing to work together to share experience and learning and work together to focus implementation on this area?
GP Practices and Primary Care Team
- Is there a clinical lead within the practice for Respiratory? Is this the sole practitioner managing these people?
- How does the practice direct/support clinicians involved in respiratory care to ensure competence and confidence? What training is offered to keep practitioners up to date? Consider the level of training for standard, advanced or expert respiratory care. See PCRS recommendations.
- How is the practice managing and risk stratifying care and service to those most in need, for example the vulnerable, house bound or those with poorly controlled symptoms?
- Has the practice considered using a variety of consultation methods, e.g. group consultations, digital?
Communicate with key stakeholders
Engage with special interest groups of people living with respiratory conditions, wider MDT, community link workers/third sector groups to understand the current situation.
