Key Takeaways
- Hackensack Meridian Health uses an electronic Parkinson’s Disease Care Pathway to guide care for hospitalized patients with Parkinson’s disease.
- The pathway calls for Parkinson’s medications to be given within 30 minutes of their scheduled time.
- An electronic alert informs your care team about a Parkinson’s diagnosis and helps prevent the use of medications that may worsen symptoms.
- The pathway also includes movement at least three times a day and upright seating during meals.
- The program began at Hackensack University Medical Center and has expanded across the Hackensack Meridian Health network.
AI generated.
Hospital care for people with Parkinson's disease (PD) is a nearly $8 billion crisis in the United States, but the financial cost pales in comparison to the human one. A staggering 1 in 6 Parkinson's patients will suffer an avoidable complication during a hospital stay, often because the system is not equipped to handle their unique, time-sensitive needs. This leads to a devastating cascade: Many are re-admitted to the hospital, discharged to a post hospital facility instead of going home, and unfortunately there is a higher mortality rate among this group of patients.
Hackensack Meridian Neuroscience Institute’s revolutionary solution, which helped form the basis of new national care recommendations, is a multi-faceted Parkinson's Disease Care Pathway built directly into the Hackensack Meridian Health’s (HMH) network’s electronic health record. The HMH Electronic Health Record (EHR) based Parkinson's disease care pathways standardizes inpatient care through several key order set interventions designed to prevent common, life-threatening failures in hospitalized PD patients.
“EHR-based Parkinson’s disease care pathways, like ours at HMH, standardize inpatient care through several key interventions designed to prevent common, life-threatening, failures in hospitalized patients living with Parkinson’s,” says Hooman Azmi, M.D., director of the Division of Functional and Restorative Neurosurgery at the Neuroscience Institute at Hackensack University Medical Center (HUMC), and associate professor of Neurosurgery at Hackensack Meridian School of Medicine. “We are preventing complications, shortening hospital stays, and saving money. This is about providing the best possible care for the patient in a way that's smarter and more efficient for everyone."
The Hackensack Meridian Health patient safety initiative, which was started at HUMC nearly 10 years ago, and has expanded throughout HMH network, is a blueprint for a more sustainable healthcare model. By preventing high-cost complications, HMH’s program shortens hospital stays, reduces readmission penalties, and improves reimbursement scores, proving that better care is also more cost-effective.
Key interventions include:
- Time-Critical Medication: A strict protocol ensures all Parkinson's medications are administered within 30 minutes of their scheduled time, preventing severe symptom exacerbations.
- Medication Safety: An EHR "Banner Flag" immediately alerts all providers to a patient's PD diagnosis and helps block contraindicated medications that can worsen symptoms.
- Proactive Mobility: A mandate to mobilize patients at least three times daily to reduce the risk of infection, delirium, and other complications associated with longer average hospital stay for PD patients.
- Aspiration Prevention: A simple but life-saving rule that patients must be sitting upright and out of bed for all meals to prevent aspiration pneumonia.
Model for a better standard of care features:
- Reduces Costs: By preventing high-cost complications and shortening the length of stay, the program directly impacts the bottom line and increases bed capacity.
- Protects Reimbursement: Lowering the 30-day readmission rate helps avoid significant CMS penalties and improves the hospital's Value-Based Purchasing score, leading to higher reimbursement.
- Enhances Market Reputation: This initiative positions the hospital as a "Parkinson's-Friendly" institution and a future Center of Excellence, attracting patients and distinguishing it from competitors.
As physicians, we are always seeking ways to improve patient outcomes. This Parkinson's Care Pathway provides a systematic, evidence-based approach to a complex disease. By standardizing care—ensuring timely medication, preventing harmful drug interactions, and promoting early mobility—we are not just treating Parkinson's, we are treating the whole patient.,” said Umer Akbar, M.D., Director of the Parkinson’s Foundation Comprehensive Care Center, Department of Neurology at Hackensack University Medical Center, and Professor of Neurology at the Hackensack Meridian School of Medicine. This initiative empowers us to prevent devastating complications, reduce hospital stays, and ultimately, send our patients home healthier. It's a powerful example of how a system-wide approach can translate into meaningful, positive results for each individual we care for."
Parkinson's disease is the second most common neurodegenerative disease in the United States, and its prevalence has more than doubled in the past generation. It was recently announced that the Hackensack Meridian Neuroscience Institute at Hackensack University Medical Center (HUMC) had become the only designated Comprehensive Care Center in New Jersey by the Parkinson’s Foundation. The prestigious Foundation recognizes the medical center’s commitment to providing outstanding, patient-centered, and team-based care. The designation comes at a critical time.
National leadership in hospital safety were among the areas that the Foundation highlighted as an area of excellence in awarding the Institute at HUMC as a center that excels in providing multidisciplinary, high-quality, clinical programs.
In addition to national leadership in hospital safety, the Parkinson’s Foundation’s recognized the HUMC Comprehensive Care Center for excellence as a dedicated and collaborative team, significant growth in specialized staff, robust psychology support, innovative "fast track" programs for Deep Brain Stimulation (DBS), and strong integration of inpatient and outpatient care.