Recipe Name:

Add Weight, Height and Waist Measurements to Patient Record

Rationale:

Recording of weight and height is a quality initiative in general practice and there are practice accreditation measures around these measurements.

Recording waist circumference is an important risk factor and is, along with the body mass index, used to identify patients at risk of chronic disease.

Target:

>= 90% active population with weight, height and waist recorded

CAT Starting Point:

  1. CAT Open
  2. Population Extract Loaded and Extract Pane “Hidden”
    1. Filter Pane open and under the ‘General’ tab ‘Active Patients’ (3x <2 years) selected (this step can be
       omitted if you want to search for all patients but for accreditation only active patients are considered).
     



RECIPE Steps missing Weight/Height

  • Click the 'Recalculate' icon in the top right corner to apply the 'active (3x in 2yrs)' filter if selected. This is optional and it will remove all patients that have less than 3 visits in the previous 2 years recorded at your clinic.
  • In the reports pane select the 'Measures/BMI/Incomplete' tab
  • This will show you the numbers of patients with missing weight, height or both values



Topbar already prompts for missing weights and/or heights on the clinical tab in the Data Cleansing app, so no additional Topbar prompt is required  to remind the clinic staff of entering missing weights and heights. You can view the patient details of those patients with missing measurements by double clicking on the respective graph.


Missing Waist

As we are going to create a prompt for Topbar, make sure you are in the "Daily View".



Waist is generally measured for adults, so you should apply an age filter. The age group of interest is dependent on your population and risk factors, but in this example we are looking at patients older than 40.

On the "General" filter tab, enter the "Start Age" in the respective box:



Then click the "Recalculate" icon in the top right to apply your filter 


 


To find patients with missing weights use the "Measurements/Waist" tab. There are two different graphs available, one for CVD risk and one for Diabetes risk - but as we are interested in patients with no waist circumference recorded it doesn't matter which graph is used.



Double click (or click once to select and then click on "Export" on the "No Waist recorded" part of the graph. This will create a list of patients with no waist recorded which can be used to create a custom prompt in Topbar following the steps outlined below.


Create a prompt to display in Topbar


Remember you need to be in the CAT4 Daily View to be able to create prompts. Other pre-requisites are:

  • Topbar is installed
  • CAT4 is linked to Topbar via Edit/Preferences/Topbar - check here for details: Linking CAT to Topbar

To start click on the 'Daily View' icon on the top of your CAT4 screen:



Once you have applied the filter(s) and displayed the patients of interest as described above, you can create a prompt that will be shown to all clinicians using Topbar if a patient meeting the prompt criteria is opened in their clinical system. The full guide is available at CAT PLUS PROMPTS and a short guide on how to create prompts in CAT4 can be found at  Creating a Prompt in CAT4

To start you have to use the drop-down menu at the bottom of the patient details report and select "Prompt at Consult - Topbar" then click on "Go" to give the new prompt a name.



The name you enter is the prompt text displayed in Topbar, so choose a simple but clear name that tells the clinician seeing the prompt what should be done.








To Export Patient List to Microsoft Excel:

1.  Click on the “Export Icon” at the top of the Patient Reidentification window.

2.  Click on “Excel”

3.   Choose a file name (eg. Allergy_Not_Recorded_Date.xls) and a location to save to (eg. Create a folder C:/ClinicalAudit/CAT Patient FollowUp)

4.  Click “Save”


The steps above will produce a list of patients with contact details in MS Excel which can then be used to:

1.   Go back through the individual patient records in the GP Clinical Desktop System (CDS) and update known records

2.  Phone patients to update their record

3.  Produce a mail merge to recall patients for follow up