ABSTRACT
Background The National Hospital for Neurology and Neurosurgery admits Parkinson's disease (PD) patients for medical management and deep brain stimulation, as well as non-PD inpatients on levodopa with dystonia or atypical Parkinsonism. Previous work showed 24.5% of administrations were outside of the recommended 30-minute time window. Methods We introduced interventions based on the Leeds Quality Improvement Project 'Get it Right on Time', adapted for local protocols and focused questionnaires. Due to cancellation of elective PD admissions during the SARS-CoV-2 crisis, we included all inpatients on levodopa. We tested differences between pre-intervention and post-intervention groups using Chi-squared (c2), with post hoc comparisons to examine individual time categories. Results We compared 177 post-intervention administration episodes to 404 in the pre-intervention group. Across all time categories, we found a significant change in administration timings between groups (c2=35.9, p<0.001). This was driven by an increase in levodopa given on time, from 11.4% to 23.2% (p<0.001) and a decrease in levodopa given up to 15 minutes late, from 31.2% to 17.5% (p<0.001). Conclusion Ward-based interventions improve timely levodopa administration. Including non-PD patients altered the study population and may have impacted results. Further work includes surveying staff to identify additional interventions and investigating a PD-only cohort.