MK Javaid Norman Collisson Lecturer in Metabolic Bone Disease, University of Oxford
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Transcript of MK Javaid Norman Collisson Lecturer in Metabolic Bone Disease, University of Oxford
Elfin project- improving patient safety, experience and outcomes for secondary fracture prevention- an update
MK JavaidNorman Collisson Lecturer in Metabolic Bone Disease, University of OxfordHon Consultant Rheumatologist, Nuffield Orthopaedic CentreLead Clinician for FRiSCy
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4260 hip fractures
~12,800 non-hip fragility fractures
Regional status: How big is the problem?
AIM:
Every patient with a fragility fracture
over the age of 50yr in South Central is: 1.Identified
2.Assessed
3.Treated effectively for at least five years
for both bone and falls health
Anetworkof everybone clinician/Nurse
Fracture Reduction in South Central PolicY group
Fracture Liaison Service > Fracture Prevention Service
Finding them all…
See patient while in trauma
Start Monitoring
Critical FirstImpressionFace to face
Complete assessment
Commitment to ongoing Patient support
Re-fracturereduction
Hip fracture ward patient
Wrist fracture clinic patient
Pelvic fracture Medical patient
Spine fractureGeneral patient
UNDER 75 years
DXA
Assess & Treat
OVER 75 years
Assess & Treat
Recommend to Patient and GP
Monitor for 5 years
Falls &GenerationsGame
CareHome
RenalCare
Dementia
2,481 patient assessed1,257 referred for DXA545 monitored
Oxford FPS 11 2011 -11 2012 x0.5 Band7, x3 Band6 (+1 maternity leave), x1.5Band4
Information streams
Datahub assist
Elfin
electronic fracture prevention patient support programme
Data input once
Output many times
GP letter
Patient informationReferrals &RequestsAudit &
reporting
Patient recall
DATABASE OUTPUTINPUTAssessment
Letter to GP
Letter to Patient
Effectivenurse use
Active Systematic Monitoring:
NON response/ re-fractureAdverse events
NON Adherence
TherapeuticTailoring
Effective fracture reduction
Patient Safety
Patient Information Prescription: Patient Experience
Interfaces
Product•Features•Standards•Systems•Performance
Milestones
1. Scoping exercise to develop product features, milestones and costs2. To develop, test and implement in Oxfordshire3. To implement in South Central hospitals 4. To engage extra-regional stakeholders for implementation
Clinician
Specialist nurse/ Administrator
NHS IT and Data protection
Patient and 3rd Sector Commissioner/ reporting
Stakeholders:
a. Data dictionary – completeb. Data entry forms –3rd round beta testingc. Output to GP and patient letter – 2nd round of beta testingd. Export – completed basic, next anonymisede. Linkage to patient registration, appointments and labs – in
progress in Oxfordf. Scheduling – completedg. Platforms – memory stick, laptop, server, integratedh. Written in xmli. Open source no licence or user feesj. Phase I sites selected and programmer found
PHASE I
PHASE II
PHASE III
PHASE IV
PHASE V
Next phase
• Complete beta testing in Oxford
• Extend throughout S Central phase II - IV
• Link with National Osteoporosis Society
• National and international availability phase V
Evaluation
• User usage
• Reduced in NHS administration costs
• Audit
• Research
Questions?