Affiliations: [a] Department of Neurology, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands | [b] Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands | [c] Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands | [d] Tilburg School of Social and Behavioral Sciences, Tranzo, Scientific center for care and welfare, The Netherlands | [e] Saw Swee Hock School of Public Health, National University of Singapore, Singapore
Correspondence to: Professor Bastiaan R. Bloem, Department of Neurology (935), Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 24 36 15202; Fax: +31 24 35 41122; E-mail: Bas.Bloem@radboudumc.nl
Abstract: Background:ParkinsonNet, a nationwide organization with regionally oriented professional health networks in TheNetherlands, aims to improve the quality of Parkinson care. Facilitation of multidisciplinary collaboration is a key objective of ParkinsonNet. Objectives:This study examined whether the concept enhances multidisciplinary collaboration between healthcare professionals involved in Parkinson care. Methods:A regional network involving 101 healthcare professionals was newly established. Participants received two questionnaires. One aimed at documenting direct working relationships (‘connections’) between professionals and the other aimed at evaluating multidisciplinary team performance. Additionally, thirteen healthcare professionals were interviewed to identify barriers and facilitators for multidisciplinary collaboration. ‘Social network analysis’ focused on sub-networks around three community hospitals at baseline and one year after the implementation. Results:The number of ‘knowing each other’ connections increased from 1431 to 2175 (52% , p < 0.001) and ‘professional contact‘ connections increased from 664 to 891 (34% , p < 0.001). Large differences between sub-networks were found, positive changes being associated with a central role of neurologists and nurse specialists committed to multidisciplinary care. The perceived team performance did not change. Participants experienced problems with information exchange and interdisciplinary communication. Generally, participants were unaware of other healthcare professionals involved in individual patients and what treatments they provide simultaneously. Conclusions:ParkinsonNet partially enhanced multidisciplinary collaboration between healthcare professionals involved in Parkinson care. Crucial facilitators of this were a central role of nurse specialists and the commitment to collaborate with and refer to expert therapists among neurologists. Additional measures are needed to further improve multidisciplinary care across different institutions and around individual patients.
Keywords: Parkinson disease, multidisciplinary communication, collaboration, social networking, community network