Keeping up with medicine is made easier when we share clinical stories with our colleagues. On this page we share brief learnings and articles that have interested our GP liaison team during the month of May. If you come across an article, video or resource you think clinical and management teams should know about, send it to firstname.lastname@example.org.
This month The British Journal of General Practice has an article extolling the virtues of providing a patient with a USB device at the time of discharge from hospital that contains any medication changes made so they can be uploaded "automatically" into the GP record (if it has the right software). Apparently providing a rapid and accurate medication discharge summary reduces errors in the transition from secondary to primary care. Whodathunk?
Imagine the clunkyness of using a USB to transfer this data. It seems like a pretty basic work around for poor connectivity. I then thought about the difficulty we have getting any sort of discharge summary (let's not talk about the difficulty getting into hospital in the first instance). Then, my fevered brain went to the proposed changes to Foundation Standards currently being trialled by the RNZCGP with their requirement for timely medication reconciliation after discharge from hospital. Getting this sorted would definitely improve patient safety, and at the moment it's a pretty time heavy process.
As an aside, please have a look at the Foundation Standards and give your feedback to the RNZCGP or directly to me. We are working with other PHOs around a formal response. My impression is that what is proposed is way beyond the minimum standard that would enable someone to safely be a GP in New Zealand. Bridging the gap between the changes made to treatment by the hospital relies heavily on the accurate and rapid transfer of the information. Having a repeat prescribing policy that prevents patients picking up a repeat script after they have been discharged form hospital is a good option as a safe backstop.
Thinking about how you input changes to medication when you do get a discharge summary. This is another task the GPs in my clinic do explicitly when they are dealing with inboxes, but I have to say we haven't audited how well it's done. Some day we will have a system based around a patient centred, universal health record, which will mean there won't be a "discharge" from a service and medicines won't need to be reconciled, because there'll only be a change in the timeline of the patient's clinical journey.
Anyone know a PMS that has that at its heart?
Have you ever recommended a book or film to a patient as part of your care? Alain De Botton is the large brain behind the School of Life and has, along with co-author John Armstrong, created a wonderful "coffee table" book exploring the concept of using reflection on classical and modern art as a way of improving skills in reflection and helping us consider our issues in relation to others.
It's too expensive to recommend to patients, but worth exploring online, and I have recommended the School of Life video series to patients from time to time as bite sized explorations of life's general angst.
I have also recommended the film About Time particularly to young married couples suffering from mild disharmony (you know these patients, the un-codable important stuff of normal GP life!). It's about a young man who realises almost too late that actually the most important thing is making the most of NOW, not getting caught up in the past. I suggest sneaking it on the TV on a Saturday night and not making a big fuss, just letting the partner realise this is really about them. Great soundtrack too.