FOCUS: How to increase drive and delivery of quality MURs outcomes

Personal Experience

By Jyoti Hadani

Background:

MUR delivery:

Four different roles - 3 busy practices.

MUR specialist 2nd pharmacist ID MUR & issues only. RP- MUR only if dispensing supported RP – low disp. MUR

PersonalBarriers Strategies

Attitude - Proactive > Reactive

Time - Confident Consultation Skill - Pre-printed material: Conditions /Inhaler/Other devices’ use

Effective communication

- Adapted MRCF - Open-ended questions- Side effects: prompts-closed questioning- Use analogies: Aids education - Keep ‘medication taking’ agenda

Organisational set-up and attitudes Barriers Strategies

Patient ID - Words: not ‘review’ but ‘check’- Motivated team work- Emerg. reqt., review due /last RD.- Repeat collection: System ID + tagged - ‘Ad-hoc’ or Appointment - Walk-in: ID labelling + MUR- Declined : deflated future opportunity

Staff motivation

Staff ID: Share + ve outcomes = feel good factor.

Organisational set-up and attitudes

Barriers Strategies

Appointment system

- Give appointment slip - Contact details - Agree reminder - Failure/cancellation

Consultation room occupied

- 2nd room - Link PH services + MUR

Low disp=Low MUR Maintain proactive : least 1 MUR - builds relationship with patient

Organisational set-up and attitudes

Barriers Strategies

MUR Quality - Good communication skills - Good patient experience, motivation- Non-judgemental - Patient centred delivery- PMR drug history check- GP review due + effective MUR/referral- Flag system: post-MUR communication

Organisational set-up and attitudes

Barriers Strategies

MUR Quantity - ID system- Regular MUR days but daily proactive target- 2nd pharmacist, high volume, MUR + workload- Labeller & frontline staff: walk-in ID + engage - Ad-hoc & appointment- Consultation room available- Laptop available- Notes + log and write referral later- Personal targets

Organisational set-up and attitudes

Barriers Strategies

Relationship with Surgery

- Understand practice and local pop. needs.

- Referral short, 1 page

- Bullet points, evidence + explanation

- Maintain good patient- GP relationship.

-Gain confidence in service provision – build rapport.

SUMMARY:

Pro-active effective service +ve impact on people’s attitude & health = Recognition

Personal experience: easier 3rd/4th MUR

FUTURE: Mandatory mini MUR. : Rx disp. = Drive delivery?

Thank youAny questions?