QI: Digital Dermatology

Cancer Referral Quality Improvement: Digital Dermatology example

This will be coordinated by PCN but likely PCN GP practices will have different issues.

  • Appoint PCN lead for the project to coordinate
  • Ensure that each practice has a Clinical Champion and Non-Clinical champion.
  • Suggest review 20 to 25, 2WW skin referrals in each practice within the PCN.

On review of the referrals, could consider:

  • Does referral contain Digital Images (Three appropriate images OR appropriate reason why missing)
  • Is there appropriate narrative describing the history of the lesion (CLINICAL REVIEW)
  • Did the patient have the 2WW Patient information leaflet (READ CODE)
  • Was any referral safety netting in place (READ CODE)
  • Was the referral accepted
  • Was there a Skin Cancer Diagnosis outcome
  • Was Cancer Care review process instigated appropriately

Could then look at individual practices processes for Digital Dermatoscope equipment

  • Practice survey to assess knowledge, competence and training needs.
    • Does everyone know what they should be doing and how to do it?
  • Practice systems or specific practice issues.
    • e.g. Wifi or Mobile Signal, access to dermatoscope etc
  • Then GP practices meet to review, generate themes and create an improvement plan for practices to implement.This maybe shared best practice from other GP practices within the PCN that are doing well.e.g.:
    • Improve readcode adoption for Patient 2WW leaflet – use of templates etc
    • Improve Safety net processes – cancer care coordinator role?
    • Improved Equipment process e.g.
      • Sign in / out register
      • Case/Box to protect equipment
      • Equipment charging check list
      • Portable battery to ensure that charge throughout the day.

Then Re-audit after 6 months to assess impact of changes in all practices.