Enquiry Categorisation - Patient Centred Themes

Categorisation of enquiries on MiDatabank

Background

The current definitions of enquiry complexity (levels 1, 2 and 3) are not meaningful outside of MI. They are based on the number of resources used or whether a written answer has been provided, and there is no consistency nationally about how to assign the levels.

A pilot of an alternative way of categorising enquiries based on 3 patient centred themes showed that ~95% of enquiries could be aligned to 3 categories: patient support & experience, treatment effectiveness & outcomes and patient safety.

As the patient centred themes have the potential to give more meaningful outcome data for MI services, UKMi Exec encourage that enquiries are categorised both by level (1, 2 or 3) and by the predominant patient centred theme.

Actions

Add 4 additional categories in the ‘Other categories’ section on the Input page of MiDatabank: Patient Support & Experience, Treatment Effectiveness & Outcomes, Patient Safety and Not applicable.

All the categories apply equally to both patient specific enquiries and situations where a patient is not identified but the information provided could impact on future clinical care of patients.

The definitions for these 4 categories are:

1. Patient Support & Experience

• Ensured availability/supply of a medicine.
• Reassured patient or clinician about the appropriateness of a regimen.
• Advised on ways to simplify a dose regimen or medicines administration.
• Supported development of local guideline, pathway or research.

2. Treatment Effectiveness & Outcomes

• Advised on the most appropriate medicine for a patient or future patients based on evidence.
• Optimised the dose schedule/preparation/administration in line with clinical evidence or experience.

3. Patient Safety

• Detected, prevented or managed a safety issue for a patient or future patients in line with clinical evidence or experience.

4. Not applicable

• None of the above categories apply 

As categorisation is based on professional judgement by individual MI Staff and the reason why the enquiry was asked, it is not possible to state exactly which enquiry types fit into which categories. 

Example

An enquiry about an adverse effect could be assigned to each category depending on its context:

Patient support & experience: a patient rings and is concerned about the adverse effects that they are getting and you advise that they are common and will reduce over time; 

Treatment effectiveness & outcomes: the doctor rings and asks for advice about timing of administration of a medicine because of adverse effects;

Patient safety: a nurse asks you if a medicine can cause a particular effect and you end up completing a yellow card report.

It is highly likely that there will be differences between how MI staff categorise, and there is no right or wrong answer. However, the basic principle is to choose the predominant patient centred theme.