A Service Evaluation of the Barriers and Facilitators to rehabilitation faced by Hospitalised Older Parkinson’s Patients at Great Western Hospital (GWH); as viewed by clinicians

Aims/Purpose:
To assess the barriers and facilitators for rehabilitation in the older Parkinson’s Disease (PD) patient population that have been admitted to Great Western Hospital (GWH); as viewed by clinicians who work within the acute inpatient setting. This was accomplished through an internal service evaluation project designed to create a GWH-specific action plan, which may also have broader applicability.

Methods:
A review of the related literature informed the development of interview questions, which guided 20 semi-structured interviews with clinicians conducted in collaboration with the project lead. The interviews were later transcribed to allow qualitative data analysis.

Results/Conclusion:
Results: A qualitative data analysis of the transcripts yielded results that were used to develop the conclusion and action plan. The vast majority of clinicians indicated that medication timing and delivery were a barrier to rehabilitation. Other areas of concern were insufficient disease knowledge and education for staff, lack of resources (time, staffing, equipment), as well as the older PD patients’ frailty and comorbidities.
Conclusions: Most staff interviewed are aware that medication administration and the other barriers were inhibiting rehabilitation at GWH, which is in line with most of the comparable PD population. Staff acknowledged that overcoming these barriers to acute rehabilitation, as well as maximising family/carer involvement, could lead to better outcomes for older PD patients in terms of quality of life, discharge, and physical function. There was no unified conclusion on where acute rehabilitation for PD patients admitted would be best served