Improving Clinic Letters in Vascular Surgery
Hypothesis
Clinic letters are:
- Not completely compliant with NICE guidance
- Don’t explain things in language patients understand
- Dictated and therefore; expensive, time-consuming to produce, and contain mistakes
Initial audit of vascular clinic letters compared to NICE guidance CG147 for peripheral arterial disease (T Gatenby, S Grant 2015):
- 100% compliance with a history being taken, pulses examined and ABPI performed.
- Only 20% of obese patients were advised to lose weight, 38% of smokers got a cessation clinic referral, and only 4% got an information leaflet
Currently vascular clinic dictations are sent to the Philippines for typing, at an average cost of £4 per letter, with an average of one notable mistake per two letters!
Solution
- Easy to use NICE guidance compliant spreadsheet for use by clinician in clinic
- Simple, & cost free, mail merge function for secretaries to create personalised patient letter
- Succinct patient information leaflet to give to patients (not shown: a4, easy to understand, initial print run of 500 done)
Step 1
The clinician fills in the 28 click-box spreadsheet, with headings for each point of the NICE CG147 guidance, clicking options from a dropdown menu for each, with 3 opportunities for free-text.
Step 2
Secretaries use the one-click Microsoft® ‘mailmerge’ to merge the spreadsheet collected clinic details for the patient, with a template word document (first sample below), which creates the clinic letter (second sample below, full letter far right).
