for OOH doctors
Although prescribing review and audit are separate core topics, many doctors have undertaken a review of their prescribing in the form of an audit. Prescribing reviews need to be undertaken against acknowledged standards, and these are widely available.
Examples are: the OOH organisation's own formulary; local formularies; Health Board prescribing guidelines and SIGN guidelines. You might decide to use an audit of your clinical practice against a published standard in one of these areas. (See audit section examples 1 and 2)
It is recognised that OOH GPs may have difficulty in reviewing certain types of prescribing when they provide only immediately necessary care (IMC) and are therefore less able to measure the effects of their care - for example with chronic disease management. However there are also important aspects of IMC that can be reviewed: giving a drug to a patient who is unknown to you and about whom you have limited information carries potentially high risks. You should be able to demonstrate that you do this as safely and effectively as possible: this includes being able to justify the use of any drugs which you decide to prescribe.
Helpful solutions - prescribing data
Ideally you need your personal data from the OOH organisation that you work for. The extent to which you have to extract data personally from the computer system will depend on the willingness of the service to help you. Encourage your employer to help you. They (the service) will ultimately benefit too.
However there is greater strength in a system of audit in which a number of OOH doctors compare themselves against the mean for the whole service and it will often be simpler for the service data manager to extract all the data once for a group of doctors than to try to facilitate each of them in turn doing this for individual personal use.
You will find below:
- Prescribing review tools with data collection sheets
- Reflective template for reviewing the outcome
- A worked example from real data
- Date created: Mon 10 Dec 2012 | File Size: 51 kb | File Time: 17 seconds @ 56 kbps
This tool includes the Reflective Template
- Date created: Mon 10 Dec 2012 | File Size: 51 kb | File Time: 9 seconds @ 56 kbps
This template has been lifted from the Prescribing Review Tool for OOH GPs as a standalone document
- Date created: Mon 10 Dec 2012 | File Size: 51 kb | File Time: 6 seconds @ 56 kbps