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Parkinson’s Project
Background
Healthwatch Stoke-on-Trent was approached by a Care Manager concerned about the lack of Parkinson’s Nurses in Stoke-on-Trent. An exploratory meeting was held with stakeholders at the Dudson Centre to discuss the issues and find a way forward.
The following slides are the result of this meeting.
Please feel free to share, adapt or add to these diagrams.
Problem Tree
Problem trees are useful for exploring cause and effect. In this case, a conversation was held around Parkinson’s, the problem tree was then populated with a member of Healthwatch staff facilitating. ResultsThe next slide is divided into 4 sections. Problems far and near, and effects far and near. You can read the diagram by starting at ‘Problems Far’, which relate s to large, difficult to change problems. Falling from this below, are the (near) problems which could be said to be caused by the far problems. This then falls into near and far effects which are the result of the problems. Its logical.
No Parkinson’s Nurses
Lack of understanding
Long wait for appointments
Not Trendy
Changeable condition
Staff shortages
No Reviews
No support information
Nobody to talk to about the issues
Poor communication
Nobody takes responsibility
Stigma
No specialist OT’s/physios
Staff attitude
Lack of knowledge and skills
No continuity of care
Impro
per
Equipment
Less Social Interaction
Lower Self esteem
GP’s shy away
No central point of control
Poor funding
Unsuitable medication
Nurses fire-fighting
Discrimination
Unidentified illness
Personal Finances suffer (no NCC budget)
Injuries from falls.
Poor mobility
Lack of dignity
UnplannedHospital Admissions
Lack of independence
Isolation
Suicide
Increased Care need
Medication at wrong time
Mental Health costs
Drop in wellbeing
Creation of ‘the unseen’
Multidisciplinary
Lower wellbeing
No Continuing NHS care.
Under resourced
Context
Mechanism
Outputs
Outcome
CMO Evaluation
CMO means Context, Mechanism, Output.
In the following slides the information from the problem tree is taken and moved into a different table. In this format it is easier to see how the context and mechanisms can produce outputs and outcomes.
It is possible to change items in the context or mechanism section to better understand how these alterations can change outcomes and outputs.
Outcome
Context
Hard to define condition
Outputs
Mechanism Lack of understanding
Not Trendy
Changeable conditionStaff
shortages Poor funding
Multidisciplinary
Long wait for appointments
Nobody takes responsibility
Staff attitude
Lack of knowledge and skills
No continuity of care
GP’s shy away
Discrimination
Nurses fire-fighting
Unidentified illness
Personal Finances suffer (no NCC budget)
Medication at wrong time
No Continuing NHS care.
No specialist OT’s/physios
Stigma
Unplanned Hospital Admissions Suicide
Mental Health costs
Creation of ‘the unseen’
Context
Outputs
Mechanism
Hard to define condition
Lack of understanding
Not Trendy
Changeable conditionStaff
shortages
Stigma
Poor funding
Multidisciplinary
Unidentified illness
Lack of knowledge and skills
No continuity of care
GP’s shy away
No central point of control
Lower Self esteem
Injuries from falls.
Poor mobility
Lack of independence
Isolation
Increased Care need
Lower wellbeing
Unplanned Hospital Admissions Suicide
Mental Health costs
Creation of ‘the unseen’
No support information
Improper Equipment
Outcome
No Parkinson’s Nurses
Next Steps
Evidence Gathering.
There is a need to evidence the outputs and outcomes.
Therefore, it would be helpful for stakeholders and partners to consider collection of case studies and data which can help prove the following.
Less Social InteractionLower Self
esteem Unsuitable medication Nurses fire-
fightingUnidentified illness
Personal Finances suffer (no NCC budget)
Injuries from falls.
Poor mobility
Lack of dignity
Unplanned Hospital Admissions
Lack of independence
IsolationSuicide
Increased Care need
Medication at wrong time
Drop in wellbeing Creation of
‘the unseen’
Lower wellbeing
No Continuing NHS care.
