title: Improving Compliance with NICE Guidelines on Parkinson's isease: A Quality Improvement Study.
abstract: Parkinson's disease can progressively affect daily function and multidisciplinary teamwork is essential to provide high quality care. The National Institute of Health and Clinical Excellence (NICE) issued guidelines regarding diagnosis, follow-up, and multidisciplinary care. This quality improvement project sought to measure and improve the compliance of service provision against the guidelines. In total, 3 audit cycles were completed. Each audit involved reviewing notes of patients attending a Parkinson's disease outpatient clinic against the PD NICE guidelines audit criteria. The first and second audits showed compliance was high for the criteria relating to initial diagnosis and referral but poor for those criteria relating to multidisciplinary referral. A pro forma stamp was recommended to be placed in the notes at each regular Parkinson's outpatient review by a specified date (October 2009), with re-audit occurring in June 2011 as part of the official hospital audit plan. Compliance to the NICE criteria improved to 100% on all criteria measured. However, it was evident from the notes that the pro forma that had been recommended by the previous audit had been in use but was not at present. In fact the pro forma had been so successful that the clinicians had made each of the criteria a routine part of their consultations and so did not need to rely on it. Use of a checklist can have a lasting improvement on compliance with NICE guidelines, even if the intervention itself is transient.
authors.affiliation: Department of Medicine, Hinchingbrooke Health Care NHS Trust, Hinchingbrooke Hospital, Hinchingbrooke Park, Huntingdon, Cambridgeshire, PE29 6NT, United Kingdom.
authors.forename: Riaz
authors.initials: R
authors.lastname: Agha
authors.affiliation: UCL Medical School, University College London, Gower Street, London, WC1E 6BT, United Kingdom.
authors.forename: Eric
authors.initials: E
authors.lastname: Edison
authors.affiliation: New College, Oxford, OX1 3BN, United Kingdom.
authors.forename: Christian
authors.initials: C
authors.lastname: Fielder Camm
authors.affiliation: Department of Medicine, Hinchingbrooke Health Care NHS Trust, Hinchingbrooke Hospital, Hinchingbrooke Park, Huntingdon, Cambridgeshire, PE29 6NT, United Kingdom.
authors.forename: Lisa
authors.initials: L
authors.lastname: Cheng
authors.affiliation: Department of Medicine, Hinchingbrooke Health Care NHS Trust, Hinchingbrooke Hospital, Hinchingbrooke Park, Huntingdon, Cambridgeshire, PE29 6NT, United Kingdom.
authors.forename: Pushpaj
authors.initials: P
authors.lastname: Gajendragadkar
authors.affiliation: Department of Medicine, Hinchingbrooke Health Care NHS Trust, Hinchingbrooke Hospital, Hinchingbrooke Park, Huntingdon, Cambridgeshire, PE29 6NT, United Kingdom.
authors.forename: Colin
authors.initials: C
authors.lastname: Borland
keywords: Checklist; NICE Guidelines; Parkinson's disease; Quality Improvement