Objective: To introduce an electronic alert when people with Parkinson’s disease (PwP) are admitted to Sherwood Forest Hospitals NHS Trust (SFH).

Background: PwP are more likely to be admitted to hospital and have longer admissions than those without PD(1,2). Parkinson’s UK and NICE have proposed standards of care for inpatients with PD, including getting medication on time, ensuring medications are only adjusted by a PD specialist, and that PD specialists are alerted when a PwP is admitted(2,3). 66% of UK hospitals don’t have an alert system in place(2), including SFH.

Method: Referrals to the PD service over 6 months were audited. 128 referrals were made; 5 per week on average. Hospital-wide there are around 12 PwP admitted weekly. Therefore under 50% are referred for specialist input. 64% of patients had been in hospital over 24 hours before referral. 16 patients were referred to the PD service more than once during admission, reflecting ongoing management issues. A system which alerts PD specialists when PwP are admitted to hospital was needed, in addition to clearer processes for ongoing follow-up throughout their admission.

The introduction of a virtual PD ward round (WR) was proposed. This required an electronic PD alert on admission to hospital. The Digital Transformation Unit facilitated the required software changes. Now, on admission PwP are tagged on NerveCentre – the local system for recording admission details and electronic prescribing.

Results: The NerveCentre flag creates an electronic list, showing all inpatient PwP. A weekly multi-disciplinary virtual WR was introduced.  A proforma is completed and filed in the medical notes. Proactive, positive interventions from the PD specialists include: constipation management, osteoporosis screening, speech and language input, cognitive assessments, dysphagia cards, and advance care planning. The flag enables remote medication reviews and audit of prescribing practice, ensuring any breaches of the ‘Get It On Time’ campaign(2) are reported, with relevant learning shared. The virtual WR provides training opportunities for junior colleagues.

Conclusion: Using the electronic flag, more comprehensive, proactive and timely reviews are possible. The PD specialists are alerted when PwP are admitted to hospital and can follow their progress remotely, including altering medication, with face-to-face reviews as required. The interventions from this project enable SFH to meet Parkinson’s UK’s recommendations.

References: 1. UK Parkinson’s Excellence Network. Hospital admissions for people with Parkinson’s [Internet]. 2020 [cited 3 November 2022]. Available from: https://parkinsonsuk.hsj.co.uk/hospital-admissions-people-parkinsonss.
2. Parkinson’s UK. Get It On Time – the case for improving medication management for Parkinson’s [Internet]. 2019 [cited 3 November 2022]. Available from: CS3380 Get it on Time Report A4.indd (parkinsons.org.uk).
3. NICE. Quality standard: Parkinson’s disease [Internet]. 2018 [cited 3 November 2022]. Available from: https://www.nice. org.uk/guidance/qs164/resources/parkinsons-disease-pdf-75545600441029.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/introduction-of-a-parkinsons-disease-virtual-ward-round/