Welcome 18th March 2009 - King's Thrombosis Centre
A Primary Care Trust Perspective NHS North Lancashire Dr Jim Gardner Medical Director & PEC Chair NHS North Lancashire [email protected]
PCT Perspective Corporate Objectives Commission health care Improve health outcomes Reduce health inequalities Achieve financial balance Patient Safety First Whole-systems thinking Not experts in VTE
VTE Improvement Cycle Understand Raise awareness Measure Set standards
Sources of data Primary Care PRIMIS QoF Secondary Care Regional Data Warehouse (SUS) CHKS Hospitals own
pathology/haematology Primary Care Prevalence from PRIMIS searches 3000 2500 2000 1500 1000 500
0 1 Total number of patients diagnosed with either DVT or PE as a % of a total GP population of 298,371 (5 practices data was not included due to discrepancies in the data collection) Primary Care Patients on Warfarin from PRIMIS search No of Pts without either DVT or PE prescribed
Warfarin between 01.11.08 - 31.01.09 505 383 No of Pts with DVT and Warfarin No of Pts with PE and
Warfarin 2811 Total number of patients prescribed Warfarin (in last 3/12) from the total GP population of 298,371 (5 practices data was not included due to discrepancies in the data collection) Annual Hospital Incidence from SUS data. 1200 1000
800 UHMB BVH LCT Other Total 600 400
200 0 20052006 20062007 20072008 Data from Cumbria & Lancashire Commissioning Intelligence Support
(CaLCIS) North Lancashire Residents (population 340,000). Benchmarked Analysis of Venous Thromboembolism 2006-2008 data Venous Thromboembolism primary or secondary position
Venous Thromboembolism Stay by type 2008 only NHS North Lancashire - Population 340,000. Length of
Venous Thromboembolism mortality rates 2008 only NHS North Lancashire Population 340,000 VTE Improvement Cycle Understand
Measure Raise awareness Set standards Commissioning for Quality What is quality?
Safety, efficacy, personalisation, outcome Advancing Quality carrots v sticks Risk Assessment for all hospital admissions embedded in contracts Financial support to providers PCT Project Manger for VTE to monitor and support Audits / Root Cause Analyses/ Trajectories
Refining DVT diagnosis in primary care >140,000 referrals for ?DVT/year in UK 80 90% do NOT have DVT Need to refine tests in primary care
Clinical Decision Process including nearpatient-testing Safely Ruling out Deep Venous Thrombosis in Primary Care. Buller et al. Ann intern Med. 2009; 150:229-235 One PBC consortium implementing. VTE Mind Map from PCT Perspective Project Plan
Understand the data and the issues
Raise awareness Set standards in contracts Support improvement initiatives Measure outcomes Link VTE to other initiatives Manage the project through a Lead Share learning Questions In our PCT area, our two acute hospital
trusts have different heparin regimes at discharge. This causes confusion for our community staff. In the interests of safety, should we (as a PCT) seek to standardise heparin protocols across our health economy? Should we, as an exemplar community, look to standardise heparin protocols across England?
Still have to manage the data systems that provide resource data (AMSRR, MFOM, CV-SHARP, etc.) even thought they don't feed DRRS-S. Take advantage of the TYCOM experts . CNAF Program POCs. CDR David "Lanezies" Lane. DRRS-N Program Manager. 757-836-8244.
OVERVIEW. This activity will introduce you to geographic information essential to the content. Revolution in the Colonies. You will read and interpret maps to learn about the locations, physical features, and human geography of the regions in North America where...
When this energy reaches the earth 30% is intercepted by the atmosphere. 0-20% reflected by the clouds. A sunbather receives the equivalent of 5 100-Watt light bulbs. Sun's Influence: On Earth The relationship between earth and the sun is complex...
* * * * * * * * Bell Ringer Tell me the difference between a single, double and triple bond. Give an example of an element that might Triple bond? Double bond Single bond? VSEPR theory states electrons pairs...
Area 4 ZC of llocos Norte- Past President Dr Purisima A. Bueno on 21 June 2018; ZC of Tuguegarao - Balbina Flojo Fermin on 12 June 2018 Area 5 ZC Makati Ayala - Wilhelmina Tanchion 8 June 2019; ZC Muntinlupa...
Verdana Arial Wingdings Competition 1_Competition MASS COMMUNICATION THEORY THEORIES OF MASS COMMUNICATION THEORIES OF MASS COMM Cultivation Theory - Gerbner CULTIVATION THEORY ASSUMPTIONS OF CULTIVATION THEORY USES & GRATIFICATION THEORY - Katz, Blumer & Gurevitch USES & GRATIFICATION ASSUMPTIONS OF...
Ready to download the document? Go ahead and hit continue!