This a collaborative initiative between the Gold Coast Horizons team, Queensland Ambulance Service (QAS) and schools to provide an individualised ambulance management plan for young people with functional neurological disorders, including pseudo seizures. This means that when a young person has an episode at school or in the community that they can be taken home to recover rather than being brought to the emergency department, significantly reducing acute hospital usage in this cohort.
Functional neurological disorders are safe and do not require acute medical treatment. When episodes occur in the community, and the young person cannot be physically moved, the ambulance is generally required to take the young person to emergency to recover from the event. When acute emergency services are already under significant stress and demand, this is an added burden for services. The ambulance may be waiting to be seen (ramping) and then or held up in addressing acute emergency calls. The emergency service is also then required to provide resources for a non-acute issue, impacting their flow. Finally, the patient and family, who already understand the disorder and would like to go home, are impacted with prolonged time waiting for recovery and clearance in the hospital.
Individualised ambulance plans for young people with functional neurological disorders
Initiative Type
Service Improvement
Status
Deliver
Added
24 August 2021
Last updated
24 August 2021
Summary
Key dates
Nov 2019
Implementation sites
Gold Coast Hospital and Health Service
Partnerships
consumers’ families, QAS, local schools and guidance officers
Aim
The overarching goal was to provide patient and family centred care by reducing the impact of the functional neurological disorder and to reduce acute emergency service utilisation.
Benefits
For the young person and their family there have been numerous benefits including:
- reduced patient anxiety, and therefore events, having an established management plan
- improved earlier integration back to school due to improved school confidence in accepting a young person with functional neurological disorder
- reduced impact on family resources - young person back to school and parents can go to work
For the emergency and hospital services the benefits include:
- more efficient use of the ambulance service as they can take patient directly home
- reduced emergency department usage
- improved patient flow in the hospital
- reduced medicalisation of a mental health disorder
Background
The effects of recurrent pseudo seizures or dissociative (non-responsive) episodes can be debilitating for the young person and their family. Functional neurological disorders, however ,are safe and do not require acute medical treatment.