Category Archives: QIP’s

Ever just get bored, family doc?

Ever just get bored, family doc?

Ever just get bored, Family doc? seagers via Compfight

Practice x 29 years, same community… bored isn’t the right word. Bad word. Medicine is never boring. There’s the irate patient to wake you up, the oblivious patient to wake up. Lab work to figure, apps to use, risks to calculate, students to teach.


But it gets a bit, well, the same. My wife, my office nurse actually, asks if anything new happened today. No. Basically, it’s, “No.”


Want something new? What about introducing a new kind of interaction? What about looking at your practice in an analytical way, doing some measurements, doing your new interaction, and seeing what happens?


GULP. That’s a QIP.


Dirty word. That’s work. That’s for your office manager MBA to figure out. That’s for your vaccine provider to do. They can do a computer survey of your patients, figure out who needs a vaccine, produce a list, figure out how to do it. QIP done.


Push submit. QIP out of the way!


There’s using the EMR to book patients. To schedule, to bill. That’s probably job one. Then there’s using the EMR to produce the medical record. Job two. It is important, and it’s more advanced than job one.


But you’re still stuck on job two, aren’t you. Come on.


Yes, yes. You have clinical connect, or some other electronic gadgetry internet wizardry that dumps lab work in your lap, and now you’re going through that, laboriously, click, categorize, file, look up old charts, occasionally graph results (that’s new, and computerized, right?) and send a message to your RN. Ok. I suppose that’s a bit different. A bit. But basically, it’s the old days, but you’re not shuffling paper.


We need to get beyond this pot hole in the road. EMR producers must find an easier way for us to process messages and lab work. It must be easier somehow. I can take a fist full of paper results and process them in virtually seconds. I know where to look, I just flip, done.


Not possible with the EMR. No flipping possible. Download, categorize, scan, click. The minutes add up. Valuable minutes that could be used looking at your practice in a creative manner.


Teachers do this all the time. They change the way they teach to fit their students. They’re little social scientists, constantly running at least informal qualitative experiments, trying this, then trying that.


I suppose we do that a bit. We look at the patient, see how they’ve done, consider our recent reading, and experiences, then try to jimmy the protocols to get better outcomes.


But it’s not methodical. It’s not written down, and it doesn’t produce a whole network change, a whole system change. That’s what is possible with a qualitative study approach to medicine.


And I admit I don’t do it. I get tired, like everyone else. It feels like you’re jamming every finger you have into leaking holes in the dike.


Want to stop? Then you need to divert the stream, or change the tide, or whatever. Working at the dike will save a few drops of water. And probably kill you with exhaustion.


I’d fallen off the log a bit. I got back into the old rut again. But I just took Gregg Jacobs insomnia course, on line, and it’s filled me with enthusiasm again. I have new tools, and a practice rife with insomniacs, just like yours.


Now I can do something. I can measure, impose a new intervention, and measure again. A whole new, formal approach to insomnia.

Ever just get bored, family doc? Anything new at work?

Breaking rules in Action Research

One of the most interesting things about action research is when you observe yourself implementing your maneuver: and see when you break rules. Breaking rules in action research is teaching yourself about you, and learning how your intervention doesn’t quite fit reality. FLEE via Compfight I’m implementing US lipid guidelines. They suggest maximum dose ofContinue Reading

Different Ways to do Action Research, QIPs

Anoop Negi via Compfight   Are there different ways to do action research? What different kinds of studies are there?   No, there’s not just one type. The typical action research project includes assessing the current situation, seeing a problem, researching it, instituting a plan for change (in some kind of physician behaviour usually), actuallyContinue Reading

Time for a Dive in Ocean?

I’ve recently downloaded my Concordia Portland capstone project, my action research, my first Quality Improvement Project (QIP). I did this late 2013. I struggled to use the PS Suite EMR to more advantage, pressed into service tablets and the Kavanagh’s “Ocean” program. It truly felt like it. A “Dive in the Ocean.” Brett Davies viaContinue Reading

Telemedicine: Just how do you eat a bonus?

Dr Ed Brown, founder and head, CEO of Ontario Telemedicine Network, gave the keynote address at the OntarioMD EMR conference in London, Ontario Mar 27, 2014. The topic, you guessed it, was the state of telemedicine in Ontario, and a look to the future.   I ate lunch. Jiuck via Compfight   I was betweenContinue Reading

Starting Quality Improvement Projects (QIP’s). Be Stellar!

Where do you focus your time and energy when you’re starting to do QIPs (Quality Improvement Projects)?   Well, where the government tells you to start! Look at to start. ecatoncheires via Compfight   Your organization has its own particular issues you want to tackle, such as patients, or physicians, that are habitually late.Continue Reading

Can you stick a carrot in a SNOMED?

The English language is a code. But computers are lousy at recognizing it, at least when it comes to medical terminology. You think hieroglyphics seem complicated? Seen SNOMED? OliBac via Compfight   You have your EMR. Unlike most MDs, you’ve actually populated your problem list with diagnoses. You thought you were done.   You’re not.Continue Reading