3712 Improving the safety and continuity of care for patients on apomorphine: a three-cycle quality improvement project

Abstract Introduction Apomorphine is an adjunct therapy used in Parkinson’s disease, requiring careful coordination at discharge. A local review identified inconsistency in discharge documentation, supply of equipment, and communication with the movement disorder team. This quality improvement project aimed to improve discharge safety and communication through implementation of a structured checklist. Method Cycle 1 involved the introduction of an apomorphine discharge checklist on Ward L5, with compliance monitored and feedback provided. In Cycle 2, further improvements included medical staff education and ensuring full stock of apomorphine equipment on the ward. In Cycle 3, the Parkinson’s Disease Nurse Specialist (PDNS) led monitoring of discharges and delivered ongoing staff training. Data were collected retrospectively across three cycles: Cycle 1: March to December 2020. Cycle 2: May–July 2021. Cycle 3: November 2022–May 2024. Results Following Cycle 1, compliance improved across all three measures (0% to 100%). In Cycle 2, a single identified case showed full compliance. In Cycle 3, of six patients: 100% of patients were discharged either with an appropriate supply of apomorphine and equipment, or the pharmacist documented that the family already had a sufficient supply of all necessary medications and equipment. 33% had movement disorder team contact details documented. 83% had an identified and satisfied receiving team. Performance dipped in Cycle 3, attributed to weekend/on-call discharges, staff turnover, and one discharge from surgical ward. Conclusion This quality improvement project showed that initial implementation of the checklist led to significant improvements in discharge safety for patients on apomorphine. However, sustainability proved challenging due to staffing changes and variability in ward practices. This work highlights the need for ongoing education ensure safety in complex medication discharges.