Parkinson’s Disease (PD) Management in a Tertiary Irish Hospital

Background There is no Irish platform for operationalizing services for People with Parkinson’s and associated disorders (PwP). The UK-wide Parkinson’s clinical audit was developed in 2009, to address concerns about the quality of care provided to PwP. Our aim was to use the UK Parkinson’s Audit cycles to drive quality improvement in our service, providing the first Irish data on quality of care for PwP. Methods The audit’s service descriptor was completed in June 2022. A sample of PwP attending Movement-Disorder clinics completed patient reported experience measure questionnaires between May - July 2022. We retrospectively collected patient data using the audit tool, which was submitted electronically. This was directly compared to our service audit data from 2019. Results In 2019, we included 30 patients in our audit – average age 67yrs, 57% male, 100% Caucasian, average duration PD 7yrs. In 2022, we included 40 patients of similar demographics. The data collected showed our services had improved or remained stable across all domains from 2019 to 2022 including medication documentation, advanced care planning, multi-disciplinary team input, non-motor, activities of daily living and bone health assessments. The service user experience remained unchanged. In 2019, our service fell in the lowest quartile of standards amongst the cohort of services audited. We improved to the top half of services audited in 2022. This was achieved by mentoring from exemplar UK services, generating a proforma to standardize assessments in outpatients, providing information to clinicians regarding local services and engaging with patients in an annual ‘Have Your Say’ day. Conclusion Our data demonstrates that repeated national audit cycles, with the patient voice at the centre, are crucial in driving quality improvement across services for PwP. As the only Irish participant in the Parkinson’s UK Audit, it's clear a National Irish Audit would be the first step in optimizing care for PwP nationally.