Multidisciplinary education transforming Parkinson's services

Our poster at the Parkinson's Movement Disorder Section World Congress has a discussion section sharing how the education we provide impacts people with Parkinson's. In it, we detail the impact that our education has had on local services through the intermodule project which delegates take on as part of the MasterClass and make their own. Some of the projects we highlighted are below, with more information about them, and links to posters and further work and articles related to that initial project. ​

A new integrated Parkinson's Hub in the north of England​

In 2019, delegate Dr Tom Mace developed an integrated, multidisciplinary team-led hub to support people with Parkinson's locally. This was done as part of his workplace intermodule project, and was inspired by speaker Dr Neil Archibald's established service for urgent and immediate multidisciplinary Parkinson's care. Since developing the service, it has been formally commissioned and recognised in a journal, whilst patient feedback is positive. Tom now speaks at other courses to share his experience and inspire colleagues the way he was inspired.

• His poster from the initial project is here: https://neurologyacademy.org/parkinsons-academy/projects/parkinsons-hub-an-integrated-pathway-for-patients-with-parkinsons-and-frailty

• The journal article in the ACNR is here: https://acnr.co.uk/articles/parkinsons-and-frailty/?hilite=tom+mace+integrated+hub

• A brief comment on Tom's journey with Neurology Academy is here https://neurologyacademy.org/articles/dr-tom-mace

Repurposing existing electronic record systems to improve in-patient medication access in Scotland ​

Recognising that timely access to Parkinson's medication in his hospital was not consistent, specialist nurse Nick Bryden decided to work with his digital and pharmacy colleagues to find a solution. A combination of targeted ward education, development of a comprehensive electronic system tied with staff working styles, ward monitoring and existing whiteboard visual prompts was put in place at no ongoing cost to the Board. The initiative also allows for daily monitoring and auditing of data across all wards. Since beginning the initiative in 2015, up to 87% of people with Parkinson's across the Board now get their time-critical medications on time.

• Nick's poster from the project is here https://neurologyacademy.org/parkinsons-academy/projects/can-existing-nhs-electronic-systems-be-used-to-improve-parkinsons-medication-administration

• He has been recognised in local parliament for the initiative: https://neurologyacademy.org/articles/parkinsons-masterclass-project-winner-acknowledged-in-scottish-parliament

Service remodelling in the South of England, with collaborative work across neurology and medicine for the elderly in England to reduce pressure on outpatient appointments​

Parkinson's clinical nurse Emily Scotney recognised issues in staff capacity, service demand and patient satisfaction. She undertook logistics and capacity planning for her intermodule project, mapping out human resource capacity, reviewing patient populations and risk stratifying them, and mapping capacity to need were combined with a move towards patient-led services.

This resulted in a completely new style of working across the neurology and medicine for the elderly teams, and a range of new service elements, including a collaborative patient pathway, a new telephone clinic, a shift in working styles to accommodate more flexible clinic times and appointments, a patient-telephone line, patient-initiated follow up, and 'safety netting' information. Patient satisfaction is high, and the workload feels more manageable to those involved in Parkinson's services.

• Her project poster is here: https://neurologyacademy.org/parkinsons-academy/projects/salisbury-hospital-geriatrician-parkinsons-team-re-modelling-the-outpatient-parkinsons-service

• A presentation she gave on the work is here https://www.youtube.com/watch?v=Ud3DvBnijY4

A new in-patient rehabilitation service for people with Parkinson's who are having falls to address bone health and manage frailty in Ireland​

Consultant geriatrician Dr Sarah Mello wanted to find out if an elective two-week in-patient rehabilitation program would have a short-term impact on frail Parkinson's patients’ function, mobility, and self-reported quality of life. The two-week programme, offered to all those who could mobilise independently (including with an aid) and were cognitively able, consisted of a consultant-led Comprehensive Geriatric Assessment and daily physiotherapy and occupational therapy sessions. All those who participated had significant improvement in activities of daily living, overall mobility, gait speed and balance from admission to discharge from the programme, as well as improved health-related quality of life indicators.

• Her project poster is available to view here: https://neurologyacademy.org/parkinsons-academy/projects/efficacy-of-an-elective-period-of-in-patient-rehabilitation-for-patients-living-with-parkinsons-disease-frailty

• Her project was featured in a booklet dedicated to parkinson's bone health, 'Supportive skeletons: addressing bone health in Parkinson's to improve outcomes (Parkinson's Academy 2022) available here https://neurologyacademy.org/parkinsons-academy/projects/education-with-impact-supportive-skeletons-addressing-bone-health-in-parkinsons-to-improve-outcomes

Complete service transformation, new nursing posts and community-to-hospital inpatient liaison service in Wales​

Dr Glesni Davies, consultant geriatrician, undertook a thorough data analysis of her local hospital and service for her intermodule project. She found that patients would prefer more regular interactions with healthcare and that there were higher than usual bed days associated with Parkinson's in-patient stays in her hospital and Parkinson's medicines were not being administered in a timely manner. She developed a comprehensive service development plan as a result, many aspects of which were put into place within two months of the plan.

Changes included improved patient communication, spanning style and language for communications, recruitment of administrative support, new clinics to accommodate demand, and improved formal and informal collaboration with other disciplines through team meetings, copying letters, added pharmacists to the inpatient alert system, and more.

• The full poster for her project can be found here: https://www.google.com/url?q=https://neurologyacademy.org/parkinsons-academy/projects/understanding-and-transforming-the-parkinsons-disease-service-at-glan-clwyd-hospital-recent-advances-and-future-directions&sa=D&source=docs&ust=1684249193217842&usg=AOvVaw3xlS_7dZuKuKso2rHefzSe