LiMBiC
team on board you will get it wrong steering group and their personal • It is important each practice designs
because no one person understands stories helped practices see the its own changes from the bottom-
the whole process. Continuous need for the change from a patient up, drawing on a depth of local
improvement is about understanding perspective. The workshops knowledge perhaps not previously
how the bits fit together before you encouraged teams of practice exploited. For instance, a practice in
can make changes. managers, patients, other practice an area of low literacy chose to offer
staff, GPs and nurses to work information in a more graphic way.
• A key message from patients was together, but also gathered groups of
that they wanted their GPs to patients and administrative staff, for • Commitment by key people is vital.
listen, and not just search for a cure instance, to ensure their views were Having practice managers who saw
immediately. This was very liberating heard. the project as part of the whole
for the professionals involved. As team’s development and GPs who
an individual tackling problems can • Any approach to service saw their practice as a learning
be frustrating, but as a team you improvement must take into account organisation empowered everyone
can take action to change systems the competing demands on people’s else to sustain their efforts to sustain
of care to meet patient needs, like time and attention. During the change and produce research-level
providing better information on project there were major changes in evidence.
back pain and different access local infrastructure and personnel.
routes to help, such as referral to It is important to use a model that Discussing future research possibilities,
physiotherapy. can adapt and work in the real Dr Carr said: “We are particularly
world. Our experience confirms interested in developing a further project
• It is important to listen to patients that making real improvements in an to build on this work, ideally using a
from the outset. There is a tendency important practice area at the same strong patient perspective. The topic
to make assumptions based on time as learning the improvement could be related to back pain but we may
a medical model of care. Patient methodology is a helpful way to consider how the approach could be
representatives were on the project address these challenges. used with other clinical issues.”
The Backcare Journal 19
backcare Winter 2009/10.indd 19 8/1/10 11:19:40
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