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Date: 24 September 2023
Rheumatology quality indicators
Continuity of care: percentage of Rheumatology outpatients who saw the same clinician or nurse at least three times out of their six most recent visits
Doctors and nurses in the Rheumatology Department see and treat patients with rheumatic diseases in their clinics at the Queen Elizabeth Hospital Birmingham (QEHB).
Patients with many different rheumatic conditions including rheumatoid arthritis, osteoarthritis, gout, systemic lupus erythematosus (SLE), Sjogren’s syndrome, polymyalgia rheumatica and vasculitis are seen.
Further information on some of the above conditions can be found by via the links section at the bottom of this page.
What is continuity of care?
Patients with long term health conditions may need to be seen regularly by a specialist hospital department. Continuity of care refers to the interactions a patient has with health professionals in a particular specialty such as Rheumatology. This regular contact between the same individuals is called continuity of care, or more precisely ‘relationship continuity’.
The reasons why a person with a long term condition needs to attend a particular hospital department may differ. For example it may be necessary to have regular blood checks or blood pressure checks, or in other cases a physical examination.
With certain rheumatic diseases, doctors and nurses provide care in the Rheumatology Clinic and some tasks are done mainly by nurses, others by doctors. Regular contact between a patient and the same carer (relationship continuity) improves patient satisfaction, improves health outcome and reduces unnecessary tests.
However it is not always possible or desirable for a patient to see the same person at each visit. For example, it may be that staff are on leave, or because junior staff need training and need to learn to work independently. Because we believe it is beneficial to have relationship continuity in hospital clinics the Rheumatology Department have chosen to measure continuity of care. We judged that if a patient was able to see the same person at least three times out of every six visits (50% of the time) to the clinic, this was sufficient good practice.
How is the Trust doing?
Percentage of Rheumatology outpatients who saw the same nurse at least three times out of their six most recent visits
|Rolling year to date (February 2019 – January 2020)||72.5%|
|Rolling 2 years (February 2018 – January 2020)||72.3%|
Percentage of Rheumatology outpatients who saw the same doctor at least three times out of their six most recent visits
|Rolling year to date (February 2019 – January 2020)||93.8%|
|Rolling 2 years (February 2018 – January 2020)||93.8%|
Higher percentage indicates better performance.
The Rheumatology Department is aiming for:
- 85% of patients to see the same nurse on at least three out of their six most recent visits
- 95% of patients to see the same doctor on at least three out of their six most recent visits
Why is this indicator important?
Seeing the same health professional when visiting a particular hospital department is important to patients and health professionals as it helps to build a good relationship between the patient and their clinicians.
There is evidence that continuity of care is associated with improved patient satisfaction, more effective use of diagnostic tests, reduced use of the Emergency Department, reduced length of stay in hospital if patients need to be admitted and better use of preventative treatments.
How do we measure this indicator?
The information about clinic appointments is recorded in the Trust’s Outpatient Management System (OPTIMS).
- Nurses: the indicator looks back at the last six appointments each patient had with a nurse and calculates how many times the patient saw the same nurse
- Doctors: the indicator looks back at the last six appointments each patient had with a doctor and calculates how many times the patient saw the same doctor
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