In this first special feature on the Excellence Network finalists, we speak to Fiona Murphy from the Neurology Parkinson's Service at Plymouth Hospitals NHS Trust about their award-winning initiatives.
There's always been great work happening in this area as Camille Carroll, the neurologist I work with, is very pro-active and has been involved in a lot of projects over the years.
However, with the appointment of 2 new Parkinson's nurses, myself and Emma Pearson, together we have been able to embed these activities into the Trust's wider service improvement strategy.
Newly diagnosed patient pathway
One of these was aimed at improving the experience of being diagnosed with Parkinson's. We have created a newly diagnosed patient pathway encompassing the first year of care.
This was developed following a survey of patients from across the South West who had recently been diagnosed to identify what needed changing in the current diagnosis experience.
The innovative part of the pathway is how the contact with patients in this first year is managed by the specialist nurses. We then feed back at MDT discussions to determine when consultant and other intervention is needed. This means that patients get the right care when they need it.
In addition, myself and Emma also see people with Parkinson's in the area who are not directly managed by Dr Carroll, but we still discuss them at the MDT meetings. That way, more patients benefit from the expertise within the service.
We also ensure that we routinely offer opportunities to get involved in research. In addition, we look to utilise technology in our service with use of the Parkinson's Kineti-Graph.
Patient satisfaction for this service has been fantastic, with 100% feeling that they were given sufficient information about their Parkinson's and that their assessment was tailored to their needs. Having been launched in September, it's still early days but it’s great to know that patients feel they are getting what they need.
Inpatient admissions guidelines
Another area we were keen to tackle was in-patient admissions. We know that for many of our patients, coming into hospital is a real source of anxiety. So we worked to create a trust-wide guideline about how to manage people with Parkinson's.
We supplemented this with education for ward staff and seeing people with Parkinson's who come into hospital on the day of their admission where possible.
We also worked with our IT department to devise a hospital alert system whereby an automated email is sent to the relevant nurses when someone goes into hospital. We have backed up this by encouraging all ward staff to refer any patients with Parkinson's to us on admission.
All of this has resulted in:
- better medicines management (with medicines reconciliation within 24 hours increasing from 57% to 80%, halving of the mean number of total doses missed and a reduction in the delay of the first dose being received from 41% of the time to 21%)
- improved patient satisfaction with the proportion of patients who feel confident that the ward staff caring for them knew enough about Parkinson's increasing from 37% to 57%
- reduced length of stay with median length of stay reduced from 18.5 days to 16 days
Find out more
We are keen for others to learn from us. Below you can find the new patient pathway (which outlines the assessment tools we use).