Abstract
Introduction
The UK Parkinson's Audit assesses whether patients with Parkinson's Disease (PD) are managed according to standards. Referring patients to physiotherapy (PT) and advising those with daytime sleepiness not to drive are two of these. In our clinic, patients identified as drivers are advised to inform the DVLA and will undergo a MOCA, sleep questionnaire and driving assessment.
Project Aim
Are we making early physiotherapy referrals and documenting driving status in new diagnosed outpatients?
Methods
Online notes of newly diagnosed patients over a 12 month period were reviewed. A clinic checklist was created and displayed in the clinic as a poster with the mnemonic:
Lasting Power of Attorney
Driving
Osteoporosis
Physiotherapy
Anticipatory Care Planning
Following introduction of the checklist a further cycle has taken place.
Results
In the initial cycle, 34 newly diagnosed patients were identified. 4 were nursing home residents and excluded from results. Of the remaining, 83% had documentation of driving status. 2 patients were drivers and 1 had evidence of completed driving assessments. 20 patients were referred to physiotherapy and a further 3 were offered (76%). 50% of referrals were within the first month of diagnosis. Following checklist introduction, 21 new PD patients were identified over 6 months. The clinic team were sent updated data throughout to encourage ongoing improvements. 95% had documentation of driving status. 9 were drivers. 6 had full driving assessment completed. 16 (76%) patients were referred to physiotherapy. 75% of these were referred within the first month.
Conclusions
Repeat data collection has shown improvement in both driving status documentation and early physiotherapy referral. The checklist reminds us of important aspects of outpatient care in PD that may otherwise get forgotten. Ongoing data collection will hopefully continue to improve.