New Hospital Care Standards for Parkinson’s Patients Gain Traction Among Experts

Of the one million people in the U.S. living with Parkinson’s disease (PD), more than 300,000 are hospitalized each year. While hospitalized, a person with PD faces significant risk of preventable harm as a result of care complications, including deterioration of motor symptoms (28% of patients), increased likelihood of readmission (51% of patients), longer hospital stays (up to 14 days longer than those without PD), discharge to care facility instead of home (63% of patients), and mortality (4% of patients).¹ The annual national cost of inpatient care is high (~$7.2 billion or ~$24,000 per hospitalized patient) and only expected to grow as the population continues to age.²

Providers have long operated without standards of care and a comprehensive toolkit for delivering safer, higher quality hospital care to people with PD. Recognizing that gap, the Parkinson’s Foundation convened an expert panel of clinical and quality improvement leaders from Hackensack Meridian Health, Henry Ford Health, and University of Florida Health to share and prioritize best practices. By April 2023, the expert panel culminated in the release of Parkinson’s Foundation Hospital Care Recommendations, which established 5 hospital care standards that promote higher reliability and zero harm³ for people with PD. The care standards are gaining national recognition through peer-reviewed publications, mostly recently in The Joint Commission Journal on Quality and Patient Safety.

Care Standards

1. All PD medications are ordered in a custom fashion according to patients’ at-home regimen.
2. All PD medications are administered within 15 minutes of patients’ at-home regimen, 100% of the time.
3. Potentially harmful medication events are eliminated, particularly for dopamine-blocking medications, agents for pain and sedatives.
4. All people with PD should mobilize three times a day if clinically appropriate and under professional supervision if necessary.
5. All people with PD should undergo screening for dysphagia within 24 hours, with measures taken to minimize the risk of aspiration pneumonia, as needed.

These care standards are founded on well-established gaps in hospital care that increase risk of harm for patients with Parkinson’s and other chronic conditions, regardless of their admitting diagnosis. These gaps include medication mismanagement (e.g., contraindicated medication, late administration), lack of sufficient and early mobility, and risk of aspiration pneumonia due to dysphagia. Hospital leaders can therefore leverage the care standards to build quality programs that improve care for not only Parkinson’s patients, but all patients with chronic conditions. Hospital leaders can also leverage the medication management and mobility tactics described in the Parkinson’s Foundation Hospital Care Recommendations to support Age-Friendly Health System activities and performance on CMS’ new Age-Friendly Measure.

These care standards are founded on well-established gaps in hospital care that increase risk of harm for patients with PD and other chronic conditions, regardless of their admitting diagnosis. These gaps include medication mismanagement (e.g., contraindicated medication, late administration), lack of sufficient and early mobility, and risk of aspiration pneumonia due to dysphagia. Hospital leaders can therefore leverage the care standards to build quality programs that improve care for not only PD patients, but all patients with chronic conditions. Hospital leaders can also leverage the medication management and mobility tactics described in the Parkinson’s Foundation Hospital Care Recommendations to support Age-Friendly Health System activities and performance on CMS’ new Age-Friendly Measure.

The Parkinson’s Foundation continues to disseminate, operationalize, and implement the care standards through the facilitation of their Hospital Care Learning Collaborative (LC). The LC, comprised of over 30 hospitals and health systems, is committed to implementing the care standards and sharing best practices to enable them. The LC meets on a bimonthly basis. The first cohort concluded in 2024; a new cohort will begin in 2025 with expanded membership.

Acknowledgements

Manatt Health is proud to have supported the Parkinson’s Foundation in convening the expert panel, developing the care standards, and facilitating the Hospital Care LC.

Peer-reviewed Publication of Care Standards

See article in BMJ Quality & Safety (June 2024)
See article in The Joint Commission Journal on Quality and Patient Safety (November 2024)

About the Parkinson’s Foundation

The Parkinson’s Foundation makes life better for people with Parkinson’s disease by improving care and advancing research toward a cure. In everything we do, we build on the energy, experience and passion of our global Parkinson’s community. Since 1957, the Parkinson’s Foundation has invested more than $449 million in Parkinson’s research and clinical care. Connect with us on Parkinson.org, Facebook, Twitter, Instagram or call 1-800-4PD-INFO (1-800-473-4636).