title: Person-Centered Care in the Home Setting for Parkinson's Disease: Operation House Call Quality of Care Pilot Study.
abstract: Objective. (1) To evaluate the feasibility of implementing and evaluating a home visit program for persons with Parkinson's disease (PD) in a rural setting. (2) To have movement disorders fellows coordinate and manage health care delivery. Background. The University of Florida, Center for Movement Disorders and Neurorestoration established Operation House Call to serve patients with PD who could not otherwise afford to travel to an expert center or to pay for medical care. PD is known to lead to significant disability, frequent hospitalization, early nursing home placement, and morbidity. Methods. This was designed as a quality improvement project. Movement disorders fellows travelled to the home(s) of underserved PD patients and coordinated their clinical care. The diagnosis of Parkinson's disease was confirmed using standardized criteria, and the Unified Parkinson's Disease Rating Scale was performed and best treatment practices were delivered. Results. All seven patients have been followed up longitudinally every 3 to 6 months in the home setting, and they remain functional and independent. None of the patients have been hospitalized for PD related complications. Each patient has a new updatable electronic medical record. All Operation House Call cases are presented during video rounds for the interdisciplinary PD team to make recommendations for care (neurology, neurosurgery, neuropsychology, psychiatry, physical therapy, occupational therapy, speech therapy, and social work). One Operation House Call patient has successfully received deep brain stimulation (DBS). Conclusion. This program is a pilot program that has demonstrated that it is possible to provide person-centered care in the home setting for PD patients. This program could provide a proof of concept for the construction of a larger visiting physician or nurse program.
authors.affiliation: University of Florida Health Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Nawaz
authors.identifier: 0000-0001-9867-4334
authors.initials: N
authors.lastname: Hack
authors.affiliation: Alpert Medical School, Brown University, Providence, RI, USA.
authors.forename: Umer
authors.initials: U
authors.lastname: Akbar
authors.affiliation: University of Florida Health Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Erin H
authors.identifier: 0000-0003-3631-8822
authors.initials: EH
authors.lastname: Monari
authors.affiliation: University of Florida Health Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Eilers
authors.affiliation: Florida Neurology Group, Ft Meyers, FL, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Thompson-Avila
authors.affiliation: Division of Neurology, Scripps Clinic Torrey Pines, San Diego, CA, USA.
authors.forename: Nelson H
authors.identifier: 0000-0001-5779-9309
authors.initials: NH
authors.lastname: Hwynn
authors.affiliation: Spectrum Health Medical Group, Michigan State University, Grand Rapids, MI, USA.
authors.forename: Ashok
authors.identifier: 0000-0003-4610-1088
authors.initials: A
authors.lastname: Sriram
authors.affiliation: Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Ihtsham
authors.identifier: 0000-0002-8001-8440
authors.initials: I
authors.lastname: Haq
authors.affiliation: Norton Healthcare, Louisville, KY, USA.
authors.forename: Angela
authors.identifier: 0000-0002-1588-844X
authors.initials: A
authors.lastname: Hardwick
authors.affiliation: University of Florida Health Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Irene A
authors.initials: IA
authors.lastname: Malaty
authors.affiliation: University of Florida Health Center for Movement Disorders and Neurorestoration, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun