Fewer than one in three patients in our region have their current alcohol consumption status recorded.
Our GP Adviser Dr Jeannie Knapp has taken a close look at how practices can use our PIP QI reports to improve their recording of patients’ alcohol consumption status.
About our PIP QI reports
North Western Melbourne Primary Health Network (NWMPHN) is continuing to provide individual quarterly PIP QI reports for any general practices in our region wanting to use data to drive improvement.
These reports are based on the 10 Measures for the Practice Incentives Program Quality Improvement (PIP QI) Incentive.
Remember: you can choose any area of data driven quality improvement for the PIP QI Incentive, as long as you are working in partnership with the PHN. The 10 Measures have been chosen as evidence-based measurements and are a good starting point for a QI activity.
In this article we take a closer look at Measure 7: Proportion of regular patients aged over 15 years old with an alcohol consumption status recorded in the previous 24 months. (Note: this means that for many patients the status must have been updated in the previous 24 months to be considered current and counted.)
Why is this important?
The consumption of alcohol is widespread within Australia and associated with many social and cultural activities. However, harmful levels of consumption are a major health issue, linked with increased risk of chronic disease, injury and premature death.
What do the statistics say?
- In 2018, alcohol was the fifth highest risk factor contributing to the burden of disease in Australia (4.5 per cent of the total burden).
- 1 in 5 (21 per cent) of Australians aged 14 and over reported being a victim of an alcohol-related incident in 2019.
- About 26 per cent of people drink more than is recommended on a single occasion, and they do this at least once each month.
Recording of alcohol status keeps our records up to date and prompts us to have conversations about alcohol and associated risk factors with appropriate patients. This can lead to evidence-based and successful interventions.
How good are we at recording this now?
In the latest data collected in the NWMPHN catchment 28.4 per cent of patients had a current alcohol consumption status recorded. If the ideal rate is 100 per cent, how do you feel about this result?
Now look at your own report.
- How do you compare to the NWMPHN average?
- How do you feel about your result? Is it higher or lower than you expected?
- What are the factors unique to your practice that you think influences the result?
Is 100 per cent ever achievable? Discussing alcohol consumption can be a sensitive topic. What is a good target to aim for? 80 or 90 per cent? Think about what is achievable at your practice.
Set a goal
Make a plan of how you are going to improve your alcohol consumption status recording rates. An important step in making changes is to have an overall goal to work towards, with a definable measure.
For example: improve the proportion of active patients with an alcohol consumption status recorded from 60 per cent to 70 per cent.
The percentage of active patients with an alcohol consumption status recorded at baseline and 6 months after making changes.
Tips to improve the recording of alcohol consumption in your practice
As a team
- Consider a team meeting and education session. Discuss correct recording (‘coding’) of alcohol consumption status with clinical staff members. Make sure everyone knows how to put the data in the correct area of the software and how to code the data correctly. Note: responses that are written in the progress notes are not able to be considered recorded.
- Brainstorm ideas with your team to help improve alcohol consumption recording. You might form a project working group.
- If the practice nurse is not busy, they might see patients who are waiting for the GP and record their alcohol consumption along with other information.
- Conduct targeted blitzes in your practice to increase recording of alcohol consumption status. For example: print some cards for reception to hand out that say “This month we are updating everyone’s alcohol consumption status. You will be asked in your consultation if your alcohol consumption status is correct is up to date.”
- Designate a particular day each week to focus on it. For example: “Alcohol Mondays”.
- Install Topbar. This helps by highlighting which patients with do not have their alcohol consumption status recorded.
- Status has to be recorded/updated within the previous 24 months to be considered current; discuss how to update the status as well as recording from scratch.
- Include alcohol consumption recording on new patient registration forms. Have a process in place for whoever translates the data into the clinical file.
- Consider adding a question about alcohol consumption in all mental health treatment plans.
Do it, study it, and act on any changes you want to make
The final step of the Plan, Do, Study, Act (PDSA) cycle is to do what you plan to do: test the ideas, study and reflect on what happened, and make changes as necessary.
For example: you might find that patients were challenged by the card handout and preferred a more personalised approach.
NEW: download a QI template for this activity
Visit our website to download a QI activity template to help you increase alcohol consumption recording and meet the requirements for PIP QI.
NWMPHN is developing an extensive library of QI activities for general practice. We will launch this library in January 2022.
NWMPHN has developed several toolkits which can assist you in tackling improvement in this measure. More information on our quality improvement program and toolkits is available on our website.
Details on how to use the PIP QI reports is available on the Pen CS website.
If you have any questions about quality improvement, please contact us on (03) 9347 1188 or email email@example.com
Visit the Alcohol Use and Dependence page on Health Pathways Melbourne for assistance on managing alcohol use within your practice.