Metro South Neurology Specialist Outpatient Department (SOPD) Initiative

Initiative Type
Model of Care
Status
Plan
Added
16 March 2018
Last updated
10 August 2020

Summary

Establishment of specific strategies for neurology specialist outpatient referrals by using specialist nursing and allied health models of care to manage the neurology SOPD waiting list.

Several areas of neurology care are particularly amenable to such a model:

  • Movement Disorders (including Parkinson’s disease and essential tremor)
  • Migraine
  • Multiple Sclerosis
  • Epilepsy
  • Neuromuscular Disorders

This is achieved by developing a:

  • Multiple Sclerosis Nurse Practitioner (MSNP) Clinic
  • Epilepsy Nurse Practitioner Clinic
  • Specialty Nurse Led Movement Disorders and DBS Review Clinic
  • Neurology Multidisciplinary Outpatient Service for patients with complex care requirements (incorporating a Clinical Nurse Consultant to co-ordinate patient centred care, Physiotherapist, Occupational Therapist, Speech Pathologist, Dietician, Neuropsychologist and Social Worker)
  • Neuroimmunology specialist nurse
  • General Practitioners with Special Interest (GPwSI) in Neurology position

This project has been the catalyst for the department to continue to adapt and change the model of care to provide the best service possible for our patients. As a result, the Neurology and Stroe Department at the Princess Alexandra (PA) Hospital now tends to be the “go to Dept” within PA when projects want a department to trial a new process of care.

Key dates
Jan 2018
Jun 2019
Implementation sites
The Princess Alexandra Hospital – linking with Logan Hospital, QEII Hospital and Redland Hospital
Partnerships
Healthcare Improvement Unit

Aim

To reduce the current neurology specialist outpatient waiting list and increase the percentage of patients seen within clinically recommended time frames by embarking upon a new model of care within the Metro South Hospital and Health Service (HHS).

Benefits

  • Improved patient satisfaction with more timely access to acute neurological care
  • Reduction in the patient waiting list and an increased percentage of patients seen within clinically recommended time frames
  • Availability of phone support if required for both the patient and GP, access to both specialist nursing and neurologist follow up, and access to allied health care staff experienced in dealing with neurological degenerative diseases

Background

Metro South Health is the largest Hospital and Health Service in Queensland, with an estimated residential population of approximately one million people (or 23 per cent of Queensland’s population). Demand for access to neurology outpatient appointments in the health service exceeds current supply and waiting list predictions, suggest the number of patients will continue to rise. A new model of care needs to be established to meet current and future demand.

Solutions Implemented

In Feb 2018 the Neurology Dept at the Princess Alexandra hospital redesigned our specialist outpatient service, embarking upon a new model of care with focus on utilising Specialist Nursing and Allied Health expertise within Metro South HHS for the provision of Neurology Outpatient Services across the HHS. The aim was to reduce our current new case waitlist and increase the percentage of patients seen within clinically recommended timeframes and provide sustainable solutions. This following initiatives were put in place:  

  • Multiple Sclerosis Nurse Practitioner (MSNP) Clinic 
  • Epilepsy Nurse Practitioner Clinic 
  • Speciality Nurse-Led Movement Disorders and DBS Review Clinic 
  • Neurology Multidisciplinary Outreach Service 
  • GP with Special Interest in Neurology 
  • Liaising with Spot on Health and utilising health pathways for clinically appropriate cases to facilitate GP management in the community  

Evaluation and Results

This revised model of care has been hugely successful in reducing our Metro South Neurology new case waiting list by 71% as at 3/8/2020, with a 93% reduction in the number of long wait patients since this re-design has been implemented. 
 

Further Reading

Institute for Healthcare Improvement: Whilst some of the models focus on solutions within a primary care setting the ideas are transferrable to our Neurology SOPD model.

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Key contact

Dr Helen Brown
Director of Neurology and Stroke
The Princess Alexandra Hospital
(07) 3176 2111
Helen.brown2@health.qld.gov.au