QI In Action: Improving the Care Outcomes of Patients with Parkinsons Disease
From Data to Excellence. Get Inspired by the 2023 QI Awards Healthcare Management Category Winner, Royal North Shore Hospital.
What makes an exceptional QI Award submission? Read this exemplar project submission by QI Award Winner 2024, Royal North Shore Hospital, NSW to learn more.
Project Outline
The Parkinson Inpatient Experience (PIE) Redesign Project is a transformative initiative established to enhance the experience and health outcomes for patients with Parkinson Disease (PD) admitted to Royal North Shore Hospital (RNSH). Driven strongly by data and performance metrics, the project successfully enhanced the experience and health outcomes for patients with Parkinson Disease, leading to positive and sustainable improvements.
Improving the Care Outcomes for Patients with Parkinsons Disease
The PIE Redesign Project addresses the unique set of challenges which patients with PD experience during hospital admissions. Both global literature and local RNSH data demonstrated that only half of PD medication doses were administered on time, i.e. within the critical 15-minute window. This increased risk exposes PD patients to avoidable complications and worse clinical symptoms.
Recognising these challenges, the RNSH sought to address the gaps in care and improve the overall inpatient experience for PD patients. Through quantitative data and extensive consultation with stakeholders, RNSH engaged in a solution design process to address the root cause of issues.
Driving Excellence and Innovation in Inpatient Medication Management
A range of original interventions were implemented across the Emergency Department, Neurology Ward and Aged Care Ward. These included:
- An electronic alert prompting doctors to prescribe PD medications at patient-specific administration times
- Electronic prompts for nurses on the medication chart to administer PD medications on time
- A prompt for nurses to administer PD medications on time built into the pharmacy dispensing software, which is automatically printed on PD medication labels.
Additionally, the PIE Project saw the implementation of interventions which creatively built on previously reported solutions that included a specifically tailored educational program for RNSH staff, formalisation of an electronic alert to promote clear identifications of PD patients and increased availability of ward stock PD medications.
Towards Sustained Change
The PIE Redesign Project exemplifies how a data-driven and patient centric approach can lead to significant improvements in patient care and outcomes.
Performance metrics post implementation and beyond show that improvements have been demonstrated and sustained. Notably, doctors report greater confidence in prescribing PD medications, which has translated into a reduction in prescribing errors, and nurses administer medications within 15 minutes of the prescribed time.
Project Update
The project has inspired a further redesign project to investigate the length of stay and high readmission rates experienced by PD patients admitted to RNSH. With longer than average hospital stays, PD patients are often at a higher risk of diminished quality of life and incur significant financial costs. The RNSH team are currently undertaking further diagnostic work and the implementation of targeted solutions in 2024 with the Parkinson Inpatient Experience Redesign Project (PIE2).
Thus far, PIE2 has identified under-recognised comorbidities and avoidable acquired complications that place this vulnerable cohort at risk. The project will develop proactive management strategies to reduce length of stay and readmission rates for PD patients to improve their hospital experience and health outcomes.
If your organisation has implemented a quality initiative within the last 2 years, we strongly encourage you to apply for this year’s Awards.
Winning the ACHS award has provided amazing recognition of the hard work and successful changes we implemented to improve medication management for people living with PD at RNSH. The award has raised the profile of the project within the hospital and helped us secure grant funding for further redesign work.
- Sue Williams
Movement Disorder CNC, Department of Neurology,
Royal North Shore Hospital
The Awards provide an opportunity to share patient-focused innovation and communicate their quality improvement achievements to the healthcare industry. Apply now and get national recognition for your improvement initiatives.
Submissions close on Friday, 6 September 2024 at 5pm (AEST).
