Gisborne Taranaki LOCALITY LOCALITY COMMUNICATION COMMUNICATION 22 November 2012 in this issue Inceptum 2012 Practice Solutions update - BPAC suite of tools The Provider website - https://provider.midlandshn.health.nz/ Congratulations Waikato and Lakes GPs Prescribing of Vitamin D Education Practice administration staff Enrolment training Immunisation Newsletter - November 2012 Inceptum 2012 Practice Solutions update - BPAC suite of tools Refer to attachment for details on Patient Prompt and BPI reports. The Provider website - https://provider.midlandshn.health.nz/ A reminder that the Provider website can be accessed at https://provider.midlandshn.health.nz/. Please save this as a bookmark/favourite in your internet browser if it s not there already. Have you read about the latest projects Midlands Health Network is working on? Check them out under the projects section. To see the full range of information, you need to enter your access code. The standard access code is p0ad, the 0 being a zero. Some practices have already set up a personalised code. To arrange your own practice code, let us know by using the Get in Touch feature. Congratulations Waikato and Lakes GPs Prescribing of Vitamin D Well done to GPs in Waikato DHB currently in fourth place and Lakes DHB in sixth place in the prescribing of Vitamin D to residents in aged residential care facilities. Evidence shows that Vitamin D supplementation can have a key role in preventing falls among older adults living in residential care facilities. For detail on the benefits of Vitamin D supplementation, prescribing criteria and dosage, refer to attachment. How can you support this programme? At each three-monthly medication review for aged care residents, be sure to include in your assessment the resident s need for vitamin D and prescribe if they are not currently on a supplement and meet the criteria. 28 22 April November 2011 2012 1
Education Practice administration staff Enrolment training A reminder that Barbara Ingendae, audit team leader at the Ministry of Health, will present this important enrolment training session for those involved in the patient enrolment process. Barbara will cover fact or fiction around the patient enrolment process, Ministry requirements for enrolment, mandatory and best practice requirements. Gisborne - Thursday 29 November 2012 from 12:30pm-2:00pm at Three Rivers Medical, 75 Customhouse Street RSVP liz.hakiwai@midlandshn.health.nz. If you are unable to attend please send your questions to your practice liaison. Current job vacancies Visit www.yournewclinic.com and http://midlands.currentjobs.co.nz/ for details on all our current job vacancies. Save these addresses as a favourite in your web browser so that you can refer back to it as needed. Some of the current vacancies include: GP Liaison Waikato. This role is only advertised within our network at https://provider.midlandshn.health.nz/news/vacancy-gp-liaison-waikato. GP Liaison Taranaki. This role is only advertised within our network at https://provider.midlandshn.health.nz/news/vacancy-gp-liaison-taranaki. Access Practice Matters The most recent editions of Practice Matters are available on the Provider site - https://provider.midlandshn.health.nz/news/practice-matters. If you wish to have Practice Matters emailed to you directly, provide your email address to your practice liaison. Attachments Practice Solutions update - BPAC suite of tools Vitamin D reduces falls in residential care facilities Immunisation Newsletter - November 2012 Join us on Facebook Twitter 28 22 April November 2011 Taranaki 2012 Practice Matters 2
Practice Solutions update - BPAC suite of tools Patient Prompt Speed issue improved! Performance improvements were made to the Patient Prompt last week. We ve had positive feedback from a number of practices that have indicated this has made a significant improvement in the time to refresh between patients. This is great news. If your practice is still having speed issues, this could be your internet, your practice network set up or your hardware, e.g. computer capacity. Turn on the prompt! If your practice is not automatically displaying the Patient Prompt, due to previous speed issues, we recommend you turn it on now. The Patient Prompt user guide has instructions on page 14 on how to have it opening automatically. Visit https://provider.midlandshn.health.nz/inceptum-2012/practicesolutions/patient-prompt. Note: the resizing issue of the prompt is due to be fixed November/December by Medtech CX - No Response Outcome Codes now displaying as Overdue If a patient has any of the following Cervical Smear Outcome Codes they will now display as overdue in Patient Prompt: NSR (No Smear Response) NR (Non Responder) GNA (Gone No Address) We are considering adding: DNR (Did not respond) NON (Non responder) GONE (Gone) NKA (No Known Address) NRR (No Response Recall) Feedback to us via your practice liaison about what Non Responder codes you are using at your practice to ensure they are included in the future.
BPI Reports Smoking brief advice and cessation reports To determine if a patient has been seen since the 1st of July, the following logic is used. The BPI report will look to see if there are any patient transactions since 1 July. It will exclude transactions that have the Non-Consultation Flag ticked. The example below shows a transaction that will be counted if seen after the 1 July 2012.
Vital D-fence An update for general practice teams August 2012 Vitamin D reduces falls in residential care facilities Introduction Why vitamin D? Evidence shows that vitamin D supplementation can have a key role in preventing falls among older adults living in residential care. The appropriate prescription of vitamin D supplements can prevent falls, through improved muscle strength and gait. At least 700IU (international units) per day of vitamin D is needed to reduce falls; monthly cholecalciferol 50,000IU (Cal-d-Forte ) or weekly alendronate with cholecalciferol (Fosamax Plus ) provides this amount. As many as 18,000 people in this group fall each year. They re reported to have a considerably higher fall frequency than those living in their own homes and are more likely to sustain fall-related injuries such as fractures. The D-fence programme aims to address this problem by promoting the role that vitamin D can play, and it is good to report that the rate of vitamin D prescribing continues to increase. Across New Zealand, 70% of residents are receiving D-Fence against falls, up from 17% in 2007. Prescribing criteria Prescribing inclusion criteria: Living in a long-term residential care facility. Prescribing exclusion criteria: Those currently on vitamin D preparations, those with known hypercalcaemia.
Dosage: Loading dose of 2 x 50,000IU vitamin D3 in first month. Maintenance dose of 50,000IU vitamin D3 per month thereafter for life. Never too late Residents who are bedbound or receiving hospital-level care still benefit from vitamin D. Professor John Campbell, Dean of Dunedin School of Medicine, comments that it is never too late to start vitamin D. People in residential care are still transferred and at risk of falls. In many cases the falls may be more severe than in their mobile counterparts, as their vitamin D levels may be extremely low. Furthermore, because of a lack of sunlight exposure, they may suffer from osteomalacia, with symptoms of bone pain that may not be complained of and not diagnosed, Professor Campbell says. adult does and thus has a 75% reduced capacity to make vitamin D3 in the skin. Even if your residents are exposed to the sun, their ability to make vitamin D is reduced meaning a supplement is important alongside sensible sun exposure. For more information on fall prevention, see an interview of Professor John Campbell at http://www.youtube.com/ watch?v=y5n4rpxkrjy& Progress Vitamin D is now prescribed to 70% of the residential care population. Sunshine is not enough Aging is associated with decreased concentrations of 7-dehydrocholesterol, the precursor of vitamin D3 in the skin. A 70-year-old has approximately 25% of the 7-dehydrocholesterol that a young What can you do? At each resident s three-monthly medication review, be sure to include in your assessment the resident s need for vitamin D. References 2 Cameron ID, Murray GR, Gillespie LD, et al. Cochrane Database of Systematic Reviews 2010, Issue 1. Bischoff-Ferrari HA, Dawson-Hughes B, Willett C, et al. JAMA. 2004; 291:1999-2006. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. BMJ 2009; 339:843-846. Holick MF, Matsuoka LY, Wortsman J. Age, vitamin D, and solar ultraviolet. Lancet 1989; 2(8671):1104-1105. ACC6508 August 2012
So as we head into the holidays where are we at with our target rates in Tairawhiti? Using the 3m target rate (inclusive of pneumococcal): 59% fully vaccinated at 06 months 78% fully vaccinated at 08 months - Must be 85% by June 2013 94% fully vaccinated at 12 months 74% fully vaccinated at 18 months 94% fully vaccinated at 24 months - 95% needs to be maintained 86% fully vaccinated at 5 years old Now the 8 month milestone target for childhood immunisations has commenced we are expected to reach 85% of 8 month olds fully immunised by June 2013. The Newborn Enrolment Policy has begun so it s important that: Antenatal Education Providers & Midwives: 1. ensure immunisation information given out to clients is correct & follows Ministry of Health Guidelines do your clients know who their GP is? Midwives / LMC s 1. ensure clients are currently registered with a GP 2. write the GP s name on the Maternity Booking Form-NOT THE PRACTICE 3. offer clients assistance with enrolling at a GP practice if needed 4. check - has your client decided on a Well Child Provider for their baby? Practices 1. your enrolment, precall/recall processes for this age group are up & running at your practice Referrals to Outreach - when can I refer? Child is 3m old & not had 6wk/3m imms? Refer immediately Child is 6m old & imms are not completed? Refer immediately Please be mindful of the time restrictions for the 8m target; don t leave it too late to refer to OIS timeliness of the referral is vital as it gives the OIS team a fighting chance of finding the family; +++ you still need to recall x 3 - but in a shorter time span Well Child Service Women, Child & Youth Tairawhiti District Health Board Private Bag 7001 Gisborne 4040 Ph 06 8691311
Thank you for all your hard work this year WHOOPING COUGH (PERTUSSIS) is still a problem within our Region PROTECTION OF OUR BABIES: Is the most important task while this outbreak is occurring. Make sure babies are vaccinated on time complete all 3 immunisation events before 6 months of age remember that a baby is not fully protected against whooping cough until they have 3 scheduled events. Make sure Preschoolers get their 4yr immunisations at 4 years of age Make sure 11 year olds get their Yr 7 Booster at school. (Yr 7 Boostrix school programme commenced September 2012). As an adult your immunity for whooping cough would have waned (as it only lasts for 8-10 years). It s important that if you are a front line health worker, work with children or have young babies in the home that you get your booster vaccination so our young babies are protected. PREGNANT WOMEN CAN ALSO HAVE THIS IMMUNISATION FROM 20 WEEKS GESTATION UP TO 2 WEEKS POST DELIVERY. This protects both the mother and baby. Please remember that the Boostrix vaccination is not funded outside the NZ Immunisation Schedule. YELLOW FEVER VACCINATION CENTRES: Please see the list below showing the nearest Vaccination Centres to Tairawhiti (as currently there is no authorised provider in Tairawhiti): Well Child Service Women, Child & Youth Tairawhiti District Health Board Private Bag 7001 Gisborne 4040 Ph 06 8691311