Methods for changing clinician behaviour Newcastle upon Tyne NHS Foundation Trust, North East of England primary care Collingwood and Central Surgeries

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MAGIC aims to change clinician behaviour. For participating practices, the shared decision making/patient experience questionnaire (SDMQ/PEQ) has helped support this goal. It informs clinicians about their performance, and regularly reminds them about the programme’s goals. Collingwood and Central Surgeries decided to find more ways of reminding clinicians about shared decision making and encouraging more of this activity.

The initial approach was to code consultation behaviour, using the national practice coding system EMIS, and then feed this back to clinicians on a regular basis. Collingwood opted to use a single code and Central surgery opted for three codes. Both practices encouraged clinicians to use the codes, began periodically searching for codes and fed activity back to clinicians.

Collingwood had early positive results, but over time, coding and feedback stopped. This was because the practice felt the code was too broad.

At Central a more rigorous approach was adopted and continued. Codes were searched and winners awarded weekly with a ‘MAGIC cup’. This regularly reminded clinicians of MAGIC, incentivised activity in a playfully competitive culture, and demonstrated shared decision making was taking place.

The MAGIC team has now negotiated to add three, more meaningful codes to EMIS computers nationally. Central surgery is now offering all clinical staff a series of possible proficiency levels.

Both practices have found the technique of coding consultations and then feeding back on activity very helpful for:

• regularly reminding the practice about MAGIC and its importance
• encouraging involvement
• providing a positive competitive element
• reinforcing education messages.