# Reducing delays in time-critical medications for Parkinson’s disease: a multifaceted, multiprofessional quality improvement project

## TL;DR

This study improved timely medication administration for Parkinson’s disease patients in hospitals through a collaborative quality improvement project.

## Contribution

A multifaceted, multiprofessional approach to reduce medication delays in Parkinson’s disease patients during hospital stays.

## Key findings

- Significant reduction in PD medication delays was achieved over 2 years.
- Changes were maintained during a 6-month sustain phase for both administration targets.
- Multiprofessional collaboration and patient-centered visualization improved outcomes.

## Abstract

When people with Parkinson’s disease (PD) are admitted to hospital, control of their symptoms can deteriorate, often due to delayed or incorrect medication administration. The aim of this project was to improve the administration of PD medicines for hospital in-patients in our trust. Specifically, we aimed to administer 95% of PD medicines within 30 minutes of the prescribed time and to eliminate delays of >60 minutes for PD medications.

To achieve these aims, we developed a multifaceted quality improvement project, led by a multidisciplinary team, that ran over a period of 2 years. The outcome measure in this project was the time delay between the time a given PD medicine was scheduled to be administered and the time at which it was recorded as having been administered by nursing staff.

The data were divided into 3 phases: a 6-month baseline phase (March 2022 to September 2022), a 24-month project phase (September 2022 to September 2024) and a 6-month sustain phase (September 2024 to March 2025). Statistical process control (SPC) charts were used to monitor medicine delays over time. Plan-do-study-act methodology was adopted within this project and a variety of interventions were employed throughout the project.

The project demonstrated a significant reduction in delays in medicines administration for patients with PD. The success of our project came from the cultivation of multiprofessional ‘ownership’ of the problem, in combination with an appreciation of the patient’s lived experience, through visualisation of how poor symptom control can impact on a person’s ability to move. Whilst it is not possible to comment on the long-term sustainability of the project, we were encouraged that the changes were maintained throughout the 6-month sustain phase for both medicine administration targets.