title: Improving service delivery for relapse management in multiple sclerosis.
abstract: This action research study was conducted over an 18 month period within a district general hospital. The study has improved the quality of the service provided to people experiencing a relapse of multiple sclerosis. The authors now identify and treat a three-fold increase in relapse patients. At least 85% of these patients are treated within 10 days of reporting symptoms to a specialist nurse. Before the study, only 12% of patients received treatment within this time. The authors' data identify what patients valued about this service and also inform debate around distress associated with relapse and how services should develop to respond to this. The study is of particular importance to the UK because the National Institute for Clinical Excellence (NICE) has published guidance to the NHS about the management of this specific patient group (NICE, 2003). This study also clearly demonstrates how specialist nursing services can combine a substantial clinical role with instigating and managing change in service delivery that results in improvements in patient care.
authors.affiliation: Gloucestershire Royal Hospital, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Warner
authors.forename: Del
authors.initials: D
authors.lastname: Thomas
authors.forename: Roswell
authors.initials: R
authors.lastname: Martin
mesh_terms: D001294:Attitude to Health; D019091:Critical Pathways / Q000592:standards; D006297:Health Services Accessibility / Q000592:standards; D006302:Health Services Research; D006767:Hospitals, District / Q000592:standards; D006769:Hospitals, General / Q000592:standards; D006801:Humans; D008485:Medical Audit; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D020380:Needs Assessment; D009720:Nurse Clinicians / Q000458:organization & administration*; D024802:Nurse's Role; D009731:Nursing Audit; D015403:Nursing Evaluation Research; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012008:Recurrence; D011795:Surveys and Questionnaires; D013997:Time Factors; D017749:Total Quality Management / Q000458:organization & administration*; D016896:Treatment Outcome