Rammya Mathew
Quality Improvement Lead
Islington GP Federation
England - London (North, East and Essex)
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Elizabeth Beech posted a new activity comment 2 years, 9 months ago
Great idea @joannabircher and @rammya-mathew and I can easily locate improvement examples, especially as we have a national PHE AntibioticGuardian award and every November a World Antibiotic Awareness Week. This is 18-24th November 2021 and it would extra good to align any AMR related activity to that week. Very happy to support this too.
An…Read more -
Joriam Ramos posted a new activity comment 2 years, 9 months ago
@rammya-mathew @brianmackenna @carol-ann-stonham I see you folks are active over here, nice to meet you!
I’m quite new here and I’m not really sure how to spread the word to this community in particular.
I’m wondering if you could help me out, also let me know if this is not the sort of content that goes well here.
I’d love to have a chat at…Read more
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Nigel Hart posted a new activity comment 3 years, 1 month ago
@rammya-mathew
I hope to pick up on a number of these themes in my presentation on 20th April.-
Thanks @nigelhart – that reminds me that I need to post details of your presentation on this forum (which is already getting a lot of interest). Unfortunately there have been issues posting in this forum for the last couple of weeks, so I’m just catching up now, as it’s been sorted today.
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Matthew Mezey posted an update in the group Primary Care 3 years, 2 months ago
I’m not involved in Primary Care (but work on Q’s central staff team), so didn’t know what to expect before the fabulous Zoom session @rammya-mathew organised with @william-eric-bostock yesterday.
It certainly made me think, as you can see from this (long!) post…
Will’s rich and deep account of treating the whole person, and catalysing a persona…Read more
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Thanks @matthewmezey for these really rich insights. Have you got a background in philosophy/ psychology? I really enjoyed Will’s talk too. I actually felt that the way Will felt with respect to consulting in primary care was very relatable. All too often we reach out for a prescription pad knowing that it’s not going to be a long term solution to…Read more
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With a research hat on, what I’d love to see is Will randomly choosing which patients get the deeper connection from him and which get something more standard. Does the deeper connection lead to higher ratings on the ‘Patient Activation Measure’ (PAM) or not? And does higher PAM lead to clinical improvements (though that’s probably being resea…Read more
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Really looking forward to seeing /hearing the recording! Have to admit that I’m not familiar with any of the literature you mention Matthew but it all sounds quite relevent to the mission of encouraging self-management, shared-decision making and person centred care.
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The work around relationship-centred care and Relational Co-ordination that Jody Hoffer Gittell, Edgar Schein and Anthony Suchman are involved in certainly feels very relevant to this.
Recording should be coming round on Wednesday, I think…
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Thank You Matthew and Rammya for your thoughtful comments. It has certainly given me a lot to think about. I have not come across the work you mention Matthew, I will add it to my (ever increasing) reading list. It certainly does sound like a similar approach. The sentiment about personalisation and not treating each other as roles certainly…Read more
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Thanks so much for sharing your insights Matthew; a very sophisticated (and actually very affirming; thank you) external view of the many facets of the role of a GP – the dialogic sitting above the purely diagnostic.(I must watch back the recording) Those insights point to some of the fundamental differences between hospital-focussed clinical…Read more
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Nigel, You may be interested in my research. I’ve been looking at a different approach to using the QI methodology. Rather than trying to improve output using tools like run charts, I apply the improvement activity to process. This methodology is called a Process Approach. Many of the QI improvement tools are relevant but much less emphasis is…Read more
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@nigelhart – this is a very thought provoking perspective. I wonder what this new model of quality improvement would look like, that is bespoke to primary care? How do we do QI that is person centred, and respects the relational care that we provide in general practice. I would love to crowd source some ideas from the group?
I’m also wondering -…Read more -
Rammya, I agree with you that improving the process efficiency will create more time for care. Care or clinical processes are not the same as business processes.
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I agree with Thomas. One of the key ways for QI in GP which addresses many of the areas of inefficiency, is better & quicker IT with automising and standardising of the many of the repetitive clinical processes we currently do on an individual basis with variable quality. Looking at human factors in GP could resolve many problems. How many…Read more
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Anne, It would be great to try adapting QI to a process rather that an output measure. If you would like to give it a go I’d like to help. Please let me know. My email is t.rose.1@bham.ac.uk
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This issue is fundamental. Medicine is siloed in a fundamental way. Doctors are grouped, trained and rewarded (think distinction/clinical excellence awards) according to their specialty. This affects the whole system (as Aneurin Bevan recognised). I doubt this problem will be sorted any time soon, but in the mean time any one-size-fits-all…Read more
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Both Matthew and Wiliam mention PAM, which has been around for some time. You might also check out the Health Confidence Score (HCS), which is newer, broader and shorter but does much the same job.
https://bmjopenquality.bmj.com/content/bmjqir/8/2/e000411.full.pdf-
Hi @william-eric-bostock, @nigelhart and @timbenson – will sit down and reply properly when I have a bit more time.
I know the Health Foundation itself was involved in work on PAM (might’ve even been connected to Islington). I’ll see if I can surface any of it…
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Enjoying this conversation on the quest for QI approaches that are more befitting of general practice than those traditionally employed in the very different context of hospital medicine!
In our work at THIS Institute, we are trying to understand operational problems in general practice using GPs’ perspectives.
We currently have a live survey…Read more
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Elizabeth Beech posted an update in the group Primary Care 3 years, 6 months ago
@rammya-mathew just noticed the About this group content and am asking if it can be amended to include all clinicians in primary care? Currently states GP, doctors and nurses! Bit embarrassed I had never noticed before…
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Hi Liz, I’ve just been given admin rights for the group and got as far as changing the group picture. I had noticed the blurb too and I am just in the process of editing this too- so don’t worry, hopefully be rectified soon. Thanks for flagging it though.
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Matthew Mezey posted a new activity comment 3 years, 7 months ago
Hi @rammya-mathew and all,
I’m afraid I was getting a bit ahead of myself on the ‘Connecting Q Locally’ fund, so please disregard those details.
There is working happening to develop the Q approach to funding local and group activity – and we will share more about it in due course. -
Elizabeth Beech posted a new activity comment 4 years, 1 month ago
Hi @rammya-mathew and apologies I have been otherwise occupied and not contributed to this. I continue to be keen to support QI in primary care and in particular am v aware the pharmacy workforce which is an increasing resource has little QI engagement, so keen to support from both aspects
Great @elizabethbeech – I’ll direct message you to try and set this up.