Development of a clinical care pathway for management of patients with Functional Neurological Disorder (FND)
Jessica Gatenby1, Kristin Fairbairn1, Sophie Pilot1 1Fiona Stanley Hospital, Murdoch, WA, Australia
Abstract
Primary Aim of this project was to develop a consensus based clinical care pathway for management of patients with Functional Neurological Disorder (FND). There is no single mechanism that has been identified as enough to explain the onset of FND, but rather several interacting factors, with recent literature stating ‘dysfunction in the health care system‘ becoming the primary perpetuating factor. As a result, patients with FND often experience delays in diagnosis, inadequate management, iatrogenic harm or delayed access to allied health, directly resulting in high re-presentation rates to hospital, longer length of stays and a revolving door system of management. Recognising these concerns for this population group, we responded by creating a working party to discuss current concerns with managing patients with FND on the Acute neurology Ward and began creating a consensus-based pathway to guide clinical care.
The working party consisted of consultant neurologists, a neuropsychiatrist, clinical psychologists, and allied health (physiotherapy, occupational therapy and speech pathology). Following comprehensive literature search, pilot of outcome measures being conducted with patients, recording of biographic information for all patients admitted to the Acute Neurology ward who received a diagnosis of FND, a clinical pathway for patients with FND was created and formalised. This pathway is in line with best available practice guidelines and continues to optimise the management of this patient population.
Acute neurology successfully was able to streamline the management for patients with FND. Our goal is to further educate other speciality areas to reduce to overall variation in care.
Biography
Jessica Gatenby, Senior Occupational Therapist, Sophie Pilot, Senior Physiotherapist and Kristin Fairbairn, Senior Speech Pathologist have worked throughout the interface of Neurology, Acute and Rehabilitation at Fiona Stanley Hospital and are current members of the FSH FND Working Group. As an MDT they have a keen interest in reducing the variation in care and management of patients with Functional Neurological Disorder and have recently been a part of the successful rollout of streamlined FND Management on the Acute Neurology Ward.