Meet the team
Associate Specialist in Dermatology and Foundation Tutor
North Bristol NHS Trust
- England - West
- Tracey Wheeler, clinical nurse specialist in dermatology
What is the challenge your project is going to address and how does it connect to your chosen theme?
Acne affects up to 80% of teenagers to some degree at a time in their lives when they are moving to adulthood and developing social skills. It has been shown to cause psychological harm and may contribute to school refusal, exam failure and anxiety amongst other issues. In this generation where Instagram and snapchat are widely used, appearance becomes even more important.
Young people are treated in primary care for a variable length of time and then wait to be seen in secondary care to discuss treatments. Offering an app that gives access to information about treatments will help patients to use their clinic appointment better and help with shared decision making.
Clinics at times where waiting rooms are not full may help as the young people are often self- conscious about their appearance which may increase their stress.
Also, offering facilitated forums for discussion including group appointments may help with psychological support as part of their management.
What does your project aim to achieve?
The objectives are to improve the clinic experience for patients with acne by allowing patients to become informed and to participate in decisions about their care. Evaluation could be by assessing their knowledge at referral and after sending them information via an app. Evaluation of their satisfaction after the clinic appointment may also show efficacy of the approach.
There may also be improvements in the patient pathways, allowing streamlining of clinics and involvement of the whole healthcare team to improve the experience of acne management in secondary care. Group appointments, telephone appointments (or Skype perhaps) with specialist nurses, clinical psychologists and prescribing pharmacists all working together.
Streamlining clinics may allow patients to see the right person in the right setting at the right time which will be resource effective. reducing the number of GP appointments and, perhaps, ineffective treatments will reduce waste and save money.
How will the project be delivered?
At the moment, patients with acne are seen , often many times, in primary care and eventually referred. the first information will help patients and GPs to manage acne effectively and to inform the time when referral for dermatology advice is needed. This will mean that patients with severe and scarring acme may be seen before long term sequelae (scarring, psychological effects) are embedded.
The plan is to involve a group of teenagers in developing the app , using their IT skills as well as their experiences as teenagers.
In a dermatology clinic, informed patients will be able to discuss care with their clinicians and may well be prepared for what treatments are available.
Involving specialist nurses in the pathway will help to increase the number of appointments available, so reducing the waiting times. Involving prescribing pharmacists in the pathway may reduce the time that patients are at the hospital for their appointments, time that is needed for education and work.
What and how is your project going to share learning throughout?
The app will be shared with the Q community as it is developed. Pathways can sometimes be specific for a particular setting but hopefully by sharing the results of the pilot in acne will help to develop other pathways in out-patient specialties. and within dermatology.
Using group appointments, telephone and Skype appointment will also be explored in this patient group and results may be able to be used for other outpatient settings.
Linking with other specialties will inform the practice (maternity “my pregnancy app” etc)
How you can contribute
- Does anyone use apps for preparing patients for outpatients
- Does anyone have prescribing pharmacists in acne clinics.
- Do group appointments work in dermatology outpatients
- Does anyone have clinical psychologists in acne clinics
|25 Jul 2019||3 months to discuss the issues raised in developing the app.|
|25 Jul 2019||6-9 months to get first iteration into clinical practice.|
|25 Jul 2019||Initial discussion with team and outpatients administration|
|2 Dec 2019||Preliminary discussion with teenagers to develop the app|