TIMELINESS OF MOTOR NEURONE DISEASE CARE– DIAGNOSIS TO SERVICE ACCESS. Issue 11 (14th October 2015)

• Record Type: Journal Article
• Authors: Shanmugarajah, Priya Devi; Tuttle, Linda; Jung, Agam
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 86:Issue 11(2015)
• Page Start: e4
• Page End: e4
• Publication Date: 2015-10-14
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2015-312379.148
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: MND is a rapidly progressive incurable neurodegenerative condition. The unpredictable rate of deterioration poses challenges to timely seamless co-ordinated care delivery. We performed an audit mapping time intervals of the patient's journey at the Leeds MND Centre to inform local service development. Objectives: Evaluate the time period from symptom onset to referral, diagnosis and access to multidisciplinary services. Method: Retrospective medical records review for newly diagnosed patients between 2010–2012. Time intervals were compared with MNDA Standards of Care and King's MND pathway. Results: 33 case notes were analysed. Median symptom onset to neurology referral was 36 weeks. Diagnosis was confirmed within 5 weeks. Post diagnosis nurse specialist review was within 2 weeks; however MDT review and consultant follow-up did not meet standards. Discussion: This audit identified the lack of a standardised diagnostic and referral pathway. It resulted in significant service review and redesign. Measurement of specific time intervals can be a practical and relevant measure for assessing variation in quality of care. The limitations of a modest sample size and limited time frames can be overcome by a national prospective audit. This will identify delays in both diagnosis and multidisciplinary team access thus ensuring equitable provision of services for patients.