A clinical process redesign project to improve outcomes and reduce care variance for people with Parkinson's disease.
Caregivers
/ statistics & numerical data
Continuity of Patient Care
/ standards
Emergency Service, Hospital
/ organization & administration
Female
Humans
Male
Medical Audit
/ methods
New South Wales
Nurses
/ statistics & numerical data
Outcome Assessment, Health Care
/ methods
Parkinson Disease
/ nursing
Program Evaluation
/ methods
Retrospective Studies
Surveys and Questionnaires
Clinical pathways
Emergency
Healthcare surveys
Interview
Medication adherence
Parkinson disease
Journal
Australasian emergency care
ISSN: 2588-994X
Titre abrégé: Australas Emerg Care
Pays: Australia
ID NLM: 101727782
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
10
09
2018
revised:
16
01
2019
accepted:
19
02
2019
pubmed:
3
5
2019
medline:
20
12
2019
entrez:
3
5
2019
Statut:
ppublish
Résumé
Redesigning clinical processes is an iterative process that seeks to reduce care variance and improve quality, safety and satisfaction for patients. The aim of this project was to optimise multidisciplinary collaboration, management and integration of clinical processes for people with Parkinson's Disease (PD) in one Emergency Department (ED). The retrospective evaluation study design explored the outcomes of a clinical process redesign project. The project included: a pre-post medical record audit, a nurse survey and patient and carer telephone interviews. The pre-post ED medical record audit revealed in favour of the post group a median reduction of 175 minutes (IQR 0:40 - 19:40) in length of stay, a 21% improvement in timely PD medication administration and 13% improvement in correctly prescribed PD medications. Patients and carers (n=47) were satisfied with their ED experience, clinicians' knowledge and management and healthcare decision engagement. Nurses (n=30) reported improved knowledge, confidence and management in caring for PD patients. This project led to enhanced multidisciplinary engagement and positive patient, clinician and service outcomes. Redesign principles can provide a pragmatic approach to improve the integration of care, change clinician behaviour, and reduce adverse outcomes within any clinical setting.
Sections du résumé
BACKGROUND
BACKGROUND
Redesigning clinical processes is an iterative process that seeks to reduce care variance and improve quality, safety and satisfaction for patients. The aim of this project was to optimise multidisciplinary collaboration, management and integration of clinical processes for people with Parkinson's Disease (PD) in one Emergency Department (ED).
METHODS
METHODS
The retrospective evaluation study design explored the outcomes of a clinical process redesign project. The project included: a pre-post medical record audit, a nurse survey and patient and carer telephone interviews.
RESULTS
RESULTS
The pre-post ED medical record audit revealed in favour of the post group a median reduction of 175 minutes (IQR 0:40 - 19:40) in length of stay, a 21% improvement in timely PD medication administration and 13% improvement in correctly prescribed PD medications. Patients and carers (n=47) were satisfied with their ED experience, clinicians' knowledge and management and healthcare decision engagement. Nurses (n=30) reported improved knowledge, confidence and management in caring for PD patients.
CONCLUSION
CONCLUSIONS
This project led to enhanced multidisciplinary engagement and positive patient, clinician and service outcomes. Redesign principles can provide a pragmatic approach to improve the integration of care, change clinician behaviour, and reduce adverse outcomes within any clinical setting.
Identifiants
pubmed: 31042525
pii: S2588-994X(19)30020-X
doi: 10.1016/j.auec.2019.02.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107-112Informations de copyright
Copyright © 2019 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.