1. Safety in Practice Leabank Health Centre Procare Facilitator: Nicki Brentnall Team members: Drs - S Chang, J Chang, N Manawadu Practice Nurses - R Giles, V Bird, A Dempsey Management Staff - D Mackie

2. Safety in Practice Organisational “Buy - In” Aim: To improve our Warfarin management system. We have approximately 40 patients on Warfarin therapy and a stable practice population. We have changed from a manual cardex system to being a fully computerised process. The manual system was well set up and very simple but was unable to be accessed by computer. Our information is now readily accessible to all our Health Professionals at the touch of a button.

3. Safety in Practice Extensive discussion in practice meetings and attendance of Safety in Practice meetings exposed us to systems other practices use and initiated this change.

4. Safety in Practice Buy-In from the patients. This involved informing the patient of the change as their INR Result would be 24 hours later than previously. We needed to reassure the patient they would not be forgotten with this new change. A problem encountered with patients testing on Fridays – therefore their results not being available until the following Monday. Easily resolved by requesting patients tests no later than Thursdays unless an exceptional circumstance occurred. Change Ideas

5. Safety in Practice Evaluation The INR is not yet defaulting automatically to our screening data therefore, we are still manually transferring information from the Patient In-Box to Screening. We have not yet eliminated this process.

6. Safety in Practice Highlights and Lowlights -What has been the experience of the team (General Practitioners, nursing and administrative staff and patients) in terms of their involvement in the improvements that have been made. Initially taking time to ensure all staff were following the processes accurately. The next step is formal annual Warfarin review for all patients.

7. Safety in Practice Achievements to date The processes and procedures have been modified to suit our surgery. INR information is now readily available to all staff. Measureable achievement: per audit, 90% of patients are having their tests done on time. Very few patients are phoning in to the surgery requesting results (obviously a time saving exercise).