Reflective Template:  Quality Improvement Activity (QIA)

This reflective template has been designed to use with SOAR (Scottish Online Appraisal Resource).  On completion, please upload this to SOAR for submitting to your appraisal to share with your appraiser.	3-step guide to completing this form:

1)	Save this form (using “Save As”) to your computer (e.g. My Documents, Desk top), and rename the file (e.g. QIA Reflection 2021)
2)	Proceed to filling out the form - when finished, Save and Close the document.
3)	Login to SOAR and Upload this file from where you had saved it (from step 1) to your current appraisal.	

The boxes will expand automatically as you type into them.
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[This example was first submitted in 2013.]

What supporting information have you provided for your QIA?
Copy of the Grampian orthopaedic pathway devised for the Grampian quality and productivity initiative; and 2 back and 1 knee case studies of patient management using the pathway. 	

What strengths or achievements does it demonstrate?
Patients with back pain and nerve root pain who are suspected of having significant prolapsed discs are referred for MRI scan from general practice. If found to have pathology are then referred to spinal service. This reduces spinal service (orthopaediac or neurosurgical) outpatient appointments by 50%. Ensures that only patients with pathology are referred to consultant clinic.
Similar pathway followed for significant knee injuries. Patients are referred for MRI scan from general practice and then referred to Orthopaediac out patient clinic if structural injury found. 	

Did you encounter any difficulties in this process?
Have been sent guidelines for suitable patients for MRI scanning . copy of document enclosed.
Limited physiotherapy availability in Grampian. Practice did have some funding for direct access to a private physiotherapy but all resources utilised.	

Have you been able to make any changes as a result of undertaking this activity?
I have expedited patient care. Previous system would have resulted in long wait for initial outpatient orthopaedic appointment followed by further wait for MRI scan. As consequence of pathway number of patients referred to consultant care reduced.	

What have you learned from undertaking this activity?
General practitioners can refer patients appropriately for expensive investigations such as MRI and as a consequence speed up the patient pathway and reduce demand on orthopaedic outpatient service.	

Is there anything else that you would like to/ need to do to follow it up?
no