Thomas J1,2, Martin L1
1NHS Fife, Dunfermline, United Kingdom, 2Queen Margaret University Edinburgh, Edinburgh, United Kingdom
Background: Parkinson´s UK is the national charity for people with Parkinson´s. Starting in 2011 they have led four audits of physiotherapy services across the United Kingdom.
Our older peoples physiotherapy department has a cohort of people with Parkinson´s who are seen in outpatient settings. We have participated in all four audits allowing us to track our improvement and service changes.
Purpose: The Physiotherapy section of the UK Parkinson´s Audit aims to establish if physiotherapy services are providing quality services for people with Parkinson's, taking into account recommendations made in evidence-based guidelines.
As a participating service our aims are:
Methods: We registered as an audit site for each cycle and completed the Parkinson's UK audit tool in each year. A patient reported experience measure (PREM) was introduced from 2015 which people attending our service returned anonymously. The completed audit tools were sent to Parkinson's UK who generated a report of our results alongside the aggregated national results.
We transferred the results onto a local database to allow comparison between audit cycles. The findings were discussed in local service planning meetings after each audit cycle with each leading to recommendations for service developments and the establishment of an action plan and implementation strategy.
Results: In all four audits our patient demographic has been close (within 5 percentage points) to the national figures, allowing benchmarking with some degree of confidence to the overall results.
In the audits that measured these outcomes:
Our waiting times from referral to treatment were over a fortnight quicker than national averages
We matched or exceeded national results with ´providing an intervention or goal plan´
We had 100% compliance with using relevant outcome measures
We were able to track our changing use in relevant outcomes measures - our use of the Berg Balance Scale has increased from using in 20% of cases to 66% over 3 audit cycles. Similarly our use of a posture measure has increased from 20% to 57%
The changes made in service delivery after the first PREM, such as establishing a multi disciplinary assessment clinic for those newly diagnosed, resulted in improvements. People with Parkinsons reported an increase in their ability to contact a Physiotherapist (from 33% to 46%) and their rating of the service as ´Excellent´ (from 16% to 46%).
Where responses have indicated an issue, such as being given enough information on diagnosis (from 41% to 38%) we are able to respond within our action planning.
Conclusion(s): Benchmarking against the national results has shown that the local service has strengths and issues that have been addressed over each audit cycle.
We have used the results to develop services that are responsive to local needs and that meet relevant guideline requirements.
Implications: Taking part in nationally organised audits is an effective method of reviewing clinical practice and service delivery.
Keywords: Audit, Parkinsons
Funding acknowledgements: None
Our older peoples physiotherapy department has a cohort of people with Parkinson´s who are seen in outpatient settings. We have participated in all four audits allowing us to track our improvement and service changes.
Purpose: The Physiotherapy section of the UK Parkinson´s Audit aims to establish if physiotherapy services are providing quality services for people with Parkinson's, taking into account recommendations made in evidence-based guidelines.
As a participating service our aims are:
- To benchmark our service against the national results
- To utilise the results to establish areas requiring improvement
- To ascertain changes in the local service building from each audit cycle
Methods: We registered as an audit site for each cycle and completed the Parkinson's UK audit tool in each year. A patient reported experience measure (PREM) was introduced from 2015 which people attending our service returned anonymously. The completed audit tools were sent to Parkinson's UK who generated a report of our results alongside the aggregated national results.
We transferred the results onto a local database to allow comparison between audit cycles. The findings were discussed in local service planning meetings after each audit cycle with each leading to recommendations for service developments and the establishment of an action plan and implementation strategy.
Results: In all four audits our patient demographic has been close (within 5 percentage points) to the national figures, allowing benchmarking with some degree of confidence to the overall results.
In the audits that measured these outcomes:
Our waiting times from referral to treatment were over a fortnight quicker than national averages
We matched or exceeded national results with ´providing an intervention or goal plan´
We had 100% compliance with using relevant outcome measures
We were able to track our changing use in relevant outcomes measures - our use of the Berg Balance Scale has increased from using in 20% of cases to 66% over 3 audit cycles. Similarly our use of a posture measure has increased from 20% to 57%
The changes made in service delivery after the first PREM, such as establishing a multi disciplinary assessment clinic for those newly diagnosed, resulted in improvements. People with Parkinsons reported an increase in their ability to contact a Physiotherapist (from 33% to 46%) and their rating of the service as ´Excellent´ (from 16% to 46%).
Where responses have indicated an issue, such as being given enough information on diagnosis (from 41% to 38%) we are able to respond within our action planning.
Conclusion(s): Benchmarking against the national results has shown that the local service has strengths and issues that have been addressed over each audit cycle.
We have used the results to develop services that are responsive to local needs and that meet relevant guideline requirements.
Implications: Taking part in nationally organised audits is an effective method of reviewing clinical practice and service delivery.
Keywords: Audit, Parkinsons
Funding acknowledgements: None
Topic: Neurology: Parkinson's disease; Service delivery/emerging roles
Ethics approval required: No
Institution: NHS Fife
Ethics committee: Clinical effectiveness department
Reason not required: Participation in national audit rather than research
All authors, affiliations and abstracts have been published as submitted.
