Table 2 Context-Mechanism-Outcome configurations concerning access and engagement
Context | Mechanism | Outcome |
|---|---|---|
General Practitioner monitoring individual patients | Focuses attention on medications | Attention focused on patients most in need of review |
General Practitioner prescribing audited and monitored in practices | Proactively conducting own audits | Practice prescribing patterns benchmarked against each other across the Clinical Commissioning Group |
Communication between Clinical Commissioning Group and General Practitioner | Real time feedback | Patients reviewed to ensure appropriate monitoring, to optimise medications, or to avoid dangerous combinations of drugs |
Clinical Commissioning Group conducting searches of prescribing based upon “projects” and “initiatives” | Prescribing patterns and trends benchmarked against national targets and guidelines | |
Clinical Commissioning Group encouraging clinicians to be engaged in more proactive safety management | Engagement of practices in using the system for feedback Voluntary engagement by clinicians Audits conducted as a means of support to General Practitioners | The effectiveness of safety initiatives audited more quickly Improved engagement with safety monitoring of prescribing |