Preparation

• Assemble your QI/data team: Include clinical, admin, and IT staff.
• Back up your database: Always back up before making bulk changes.
• Ensure access to POLAR or equivalent audit tool: For reporting and cross-checks.
• Review relevant guides:
• Best Practice Knowledge Base
• Medical Director

Step-by-step guide

Step 1: Identify Patients with an Active MHTP

Best Practice Premier

• Search for patients with an active MHTP:
• Go to Utilities > Search > Patients.
• Set criteria for patients with a MHTP (use relevant item numbers or diagnosis codes).
• Export or print the list for review.
• Best Practice Knowledge Base

Medical Director

• Search for patients with an active MHTP:
• Go to Search > Patients.
• Filter by patients with a MHTP (use relevant item numbers or diagnosis codes).
• Export or print the list for review.
• Medical Director Help

Step 2: Identify Patients Who Have Not Attended in 6 Months

Best Practice Premier

• Add attendance filter:
• In the search criteria, add “Last visit date” or “Not seen since” and set the cut-off to 6 months ago.
• Combine with the MHTP filter to find patients with an active MHTP who have not attended in 6 months.
• Export or print the list for clinical review.

Medical Director

• Add attendance filter:
• In the search criteria, add “Last visit date” or “Not seen since” and set the cut-off to 6 months ago.
• Combine with the MHTP filter to find patients with an active MHTP who have not attended in 6 months.
• Export or print the list for clinical review.

Step 3: Clinical Review and Action

• Review the list with clinicians:
• Determine if each patient requires follow-up or recall.
• Exclude patients who are no longer clinically indicated for follow-up.
• Contact eligible patients:
• Use recall systems (letters, SMS, phone calls) to invite patients for a review appointment.
• Document all contact attempts and outcomes in the patient record.

Step 4: Documentation and Reflection

• Record outcomes in the patient record.
• Update the register to reflect new or updated MHTPs and attendance.
• Track the number of patients identified, contacted, and who attended follow-up.
• Use an audit worksheet to document baseline and post-intervention numbers.
• Reflect as a team: What worked? What could be improved for next cycle?

Key Tips and Resources

• Best Practice Premier:
• Best Practice Knowledge Base
• Medical Director:
• Medical Director Help
• POLAR:
• Use POLAR reports to cross-check and validate your findings.

Summary Table