Type: Protocol
Purpose:
This protocol alerts clinicians to patients that have had more than 12 issues of beta-agonist within the last 12 months, putting the patient at increased risk of death ( as highlighted b y the national review of asthma deaths ).
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol alert is dependent on accurate coded information within EMIS web, contemporaneously recording medication
Automatic triggers
System Trigger: Issue a drug, load record, update record
Run mode: Always run
Enable trigger for: All job categories
Add Drug group, approved name or ingredient: ventolin includes all child codes, terbutaline includes all child codes, salbutamol includes all child codes
Fitting your practice
You need to consider how many alerts you have active within your practice. This would fit well following an audit to look at patients who are highlighted as high risk by the national review of asthma deaths searches and then a period of time where this is focussed on within the practice.
HP095 Pancreatic Cancer Suspicion
Type: Protocol Alert
Purpose:
This protocol alert highlights to the clinician where there may be a risk of pancreatic cancer according to the NICE 2015 guidelines - including patients over the age of 60 with: diarrhoea/back pain/abdominal pain/nausea or vomiting/constipation or new onset
diabetes.
Supporting key areas
Safe
Managing risks
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording both medication and other clinical care elements.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
You need to let your clinicians know that this protocol will flag where they need to consider pancreatic cancer.
HP096 Both PPI & Thyroxine Alert
Type: Protocol Alert
Purpose:
Thyroxine needs an acidic environment for best absorption. Where patients are on a PPI, the impact of this on the absorption of thyroxine will be highlighted to our team.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Staff skills and knowledge
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording both medication and other clinical care elements.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
No adjustment is required, the protocol is self explanatory.
HP097 Cancer Care Review Needed
Type: Protocol
Purpose:
When adding a new diagnosis of cancer , this will highlight to the user that a review is needed within 3 months of the diagnosis and also code a due diary entry to this effect. This is useful for administration teams to make them aware of the requirements for QOF, and also to ensure patients are reviewed with their GP in a timely fashion.
Supporting key areas
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Concerns and complaints
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording cancer diagnoses as well as cancer care reviews.
Automatic triggers
System Trigger: Add a code
Run mode: Always run
Enable trigger for: All job categories
Clinical codes:
Malignant neoplasm of lip, oral cavity and pharynx C= 271323007 D= 4406052010,
Malignant neoplasm of digestive organs and peritoneum C= 269456006 D= 725971000006119,
Malignant neoplasm of thoracic cavity structure C= 428100006 D= 2691955010,
Malignant neoplasm of bone, connective tissue, skin and breast C= 271467005 D= 406262013,
Malignant neoplasm of genitourinary organ C= 271468000 D= 40623015,
Malignant neoplastic disease C= 363346000 D= 1208875016,
Malignant neoplasm of lymphatic and hematopoietic tissue C= 269475001 D= 403705015.
Fitting your practice
Your clinical coders (and other team members) need to know to take action when they see this alert. You may wish to setup a recall search to look for the due diary entry for patients (albeit many surgeries use the QOF reports to identify these patients).
HP099 Palliative Care Stage Alert
Type: Protocol Alert
Purpose:
Where a patient is on the palliative care register, this protocol alert will highlight which stage they are recorded as being at (or if they don't have a stage recorded). The user can update the stage by double clicking on the protocol alert.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management o f risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording palliative care status. Another of our handy protocols highlights patients who should possibly be enrolled on the palliative care register.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Your team need to know that this information will be recorded in the protocol alert box. Some training for non-clinicians may be necessary so that they understand the implications and what action may need to be taken.
HP100 Palliative Care Preferred Place of Death
Type: Protocol Alert
Purpose:
Where a patient is on the palliative care register, this protocol alert will highlight if they have had a discussion about preferred place of death. The user can update the details by double clicking on the protocol alert.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparison with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording palliative care status. Another of our handy protocols highlights patients who should possibly be enrolled on the palliative care.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Your team need to know that this information will be highlighted in the protocol alert box. This may be a useful alert to set after working your way through the QI standards for QOF palliative carer.
HP101 High Risk Diabetes + PCOS
Type: Protocol alert
Purpose:
To flag where patients are at high risk of diabetes and have not had a recent blood test to monitor that risk.
Supporting key areas
Safe
Managing risks
Self care and treatment
Effective
Assessing needs and delivering evidence-based treatment
Supporting people to lead healthier lives
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This is dependent on you having coded high risk diabetic patients correctly, but also looks at previous HbA1cs and automatically launches.
Automatic triggers
System Trigger: Load record
Run mode: Always run
Enable trigger for: All clinical team
Fitting your practice
Alert your team that a protocol alert will highlight where patients may need an HbA1c doing. Care needs to be taken that this may not have been within your own practice and you need to make sure that your own guidelines on exception recording are adhered to.
HP102 Consider Palliative Care Radar
Type: Protocol Alert
Purpose:
Where a patient has codes that suggest that they may have palliative care needs, this protocol alert will make the clinician consider if they should enroll them on the palliative care register. The user can update the details by double clicking on the protocol alert.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording cancer and other diagnoses.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
Your team need to know that this information will be highlighted in the protocol alert box. This may be a useful alert to set after working your way through the QI standards for QOF palliative carer.
HP103 Anticholinergic Burden Awareness (ACB1)
Type: Protocol Alert
Purpose:
This protocol alert will highlight to clinicians where a patient is over the age of 65 and has an anticholinergic score of 3 or more. Double clicking on the alert will take you to a template which highlights the drugs that are responsible for the ACB score.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Monitoring outcomes and comparing with similar services
Staff skills and knowledge
How staff, teams and services work together
Supporting people to live healthier lives
Consent to care and treatment
Caring
Involving people in decisions about their care
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership capacity and capability
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This protocol is dependent on accurate coded information within EMIS web, contemporaneously recording medication issues.
Automatic triggers
System Trigger: Load record and update record
Run mode: Always run
Enable trigger for: All clinical job categories
Fitting your practice
Your team need to know that this information will be highlighted in the protocol alert box. This may be a useful alert to set after working your way through the QI standards for medication reviews.
Type: Protocol alert
Purpose:
To highlight to team members where consent to share information with other people exists.
Supporting key areas
Safe
Safeguarding and protection from abuse
Managing risks
Effective
How staff, teams and services work together
Consent to care and treatment
Caring
Kindness, respect and compassion
Involving people in decisions about their care
Privacy and dignity
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Vision and strategy
Culture of the organisation
Governance and management
Management of risk and performance
Management of information
Engagement and involvement
Learning, improvement and innovation
System Dependencies:
This protocol relies on your team coding consent to share data using the code 9NdG "Consent to
share patient data with specified 3rd party" and then entering the details of the third party with the relationship
Automatic triggers
System Trigger: Load patient record
Run mode: Always run
Enable trigger for: All job categories
Fitting your practice
Your team need to know about adding consent to the record, and also that the alert will appear in the bottom right hand corner alert box where this consent exists. If you are using patient alerts to record this currently, you would need to have a plan in place to move over to this way of recording consent.
HP108 Warfarin interactions
Type: Protocol
Purpose:
To flag where antibiotics have been prescribed for patients on warfarin and ensure a task is sent to the nursing team to organise an INR is organised in a week.
Supporting key areas
Safe
Managing risks
Medicines management
Effective
Assessing needs and delivering evidence-based treatment
Responsive
Person-centred care
Taking account of the needs of different people
Timely access to care and treatment
Well-led
Leadership and capability
Vision and strategy
Culture of the organisation
Management of risk and performance
Management of information
Learning, improvement and innovation
System Dependencies:
This is dependent on you using EMIS to record all issues of medication, but otherwise automatically launches
Automatic triggers
System Trigger: Add a drug
Run mode: Always run
Enable trigger for: All clinical prescribers
Add Drug group, approved name or ingredient: all antibiotics excluding topical treatments
Fitting your practice
Alert your team that if they prescribe antibiotics to patients on warfarin that they will be nudged to arrange a follow up INR in a week by the protocol.