Innovations

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Innovations - quality assured physiotherapy initiatives

Our quality assured examples of successful initiatives aim to promote physiotherapy as an innovative and cost effective approach to improving patient pathways and promoting public health. We welcome examples and case studies from all aspects of physiotherapy practice, research, education, and service delivery.

You can either filter the innovations by 'Region' or 'Type' or use the keyword search above to find specific words or phrases. 

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Collaborative cross-agency service delivery to address public health issues within an MSK setting: evaluation of ´Healthy Mind, Health Body´

Patients accessing Physiotherapy in Blackburn demonstrate multiple co-morbidities, physical and biopsychosocial issues. This unique, cost-effective, collaborative service redesign addresses the specific co-existing health issues and behaviours associated with MSK conditions in Blackburn and offers a cost-effective, high quality solution to empower and support the MSK population to better manage their own health and well-being in alignment with Public Health England priorities.

Service evaluation of the Anterior Cruciate Ligament Deficient Induction Clinic (ACLD) and Rehabilitation Class.

Historically, at GSTFT, patients with ACL pathology have been managed in weekly exercise classes. Anecdotally, Physiotherapists felt that they were unable to effectively manage both the post-operative and ACL deficient (ACLD) populations due to high class numbers. After an internal service evaluation and audit, a unique ACLD pathway was established to separate the ACLD population, and better manage both ACL cohorts. This included a specific fortnightly ACLD Induction Clinic and ACLD rehabilitation class.

This data collection aimed to:

  • Evaluate the demand for the ACLD pathway, including the new ACLD rehabilitation class, and analyse patient demographics
  • Ensure the ACLD pathway is utilised correctly, by monitoring patients being referred
  • Start analyzing the data and trends of patient attendance and onward management in the ACLD rehabilitation class and begin early root cause analysis.
  • Commence a systematic review around the quality of pre-operative physiotherapy intervention and how this effects outcomes post-operatively, in order to guide the temporality and content of our ACLD rehabilitation class.

Reducing emergency admissions for primary constipation: a pilot study to cut costs in an acute hospital trust.

Constipation is a common condition that impacts quality of life, often causing psychological distress and incurring considerable healthcare costs in terms of unnecessary emergency admissions due to poor management.

Aintree University Hospital offers one of the only Specialist Physiotherapy led healthy bowel clinics (HBC) in the UK that assess, treat and manage patients presenting with functional bowel problems, including constipation. Patients referred into the service are directed straight to HBC and the majority will never see a medic. The service is run solely by Physiotherapists. We can refer for appropriate tests (transit marker studies, defecating proctograms, anorectal physiology and various blood tests). We independently interpret results and decide on appropriate treatment/management. Our service offers specialist assessment, medication management, lifestyle advice, pelvic floor re-education, Posterior Tibial Nerve Stimulation, rectal irrigation and cognitive behavioural therapy. The majority of our patients are managed conservatively as surgery is rarely an option.

From December 2013 to November 2014, Hospital Episode Statistics (HES) data showed that 301 patients were admitted to Aintree University Hospital with a primary diagnosis of constipation, 216 of these through the Accident and Emergency Department (AED), with an average length of stay of 3.3 days. The HBC Physiotherapists recognised that there should be a more cost-effective, efficient way to manage these patients and proposed a new pathway. The pathway allows patients to manage their symptoms in their own home with support from specialist Physiotherapists, enhancing patient dignity. Assessment identified 5 patients with potential red flag symptoms and allowed appropriate onward referral.

The effectiveness of circuit training on physical ability in palliative care.

Exercise and physical activity is increasingly being encouraged with palliative care patients due to emerging evidence suggesting the physical and psychosocial benefits to patients. This small, local audit analyses the changes in physical outcome measures of a group of patients undertaking a weekly circuit exercise group.

Assessing the impact of Physiotherapy Training on Emotional Wellbeing.

1 in 4 people experience mental health problems in any given year, 1 in 6 experience work related stress, depression or anxiety. Only 25% of those experiencing emotional distress seek and receive treatment, with many being dependent on the informal support of family or colleagues.

Physiotherapists are also encouraged to investigate Biopsychosocial issues with their patients, through management of persistent pain conditions and may not feel equipped to successfully interpret or manage the information that they receive from the patient. This additional stress can also impact on the Physiotherapists emotional wellbeing and have an impact on patient care.

The aim of this project was to ensure that all Physiotherapists have an appropriate level of emotional literacy so that they are able read/notice the signs of emotional distress in themselves and others and then act appropriately to support themself and others.

Lung ultrasound in the management of patients with cystic fibrosis: A literature review

Adults and children diagnosed with cystic fibrosis (CF) are regularly exposed to ionising radiation, from chest radiographs (CXR) and computed tomography (CT). This poses an issue as life expectancy has increased into the fifth decade of life.

Lung ultrasound (LUS) has the ability to assess many lung pathologies experienced in CF with accuracy close to CT but without the exposure to ionising radiation. The purpose of this review is to explore the literature to establish if LUS is being used to aid the management of patients with CF.

The use of a standardised outcome measure within the Musculoskeletal Physiotherapy Services across a Trust in Staffordshire

Musculoskeletal (MSK) physiotherapy teams within Midlands Partnership NHS Foundation Trust (MPFT) historically used a variety of outcome measures including the EuroQol (EQ-5D-5L) alongside condition specific PROMS and a patient experience-reported experience measure, in line with Chartered Society of Physiotherapy (CSP) recommendations. However, teams used different outcome measures and data collection, inputting and analysis methods varied considerably.

In 2017, the MSK Health Questionnaire (MSK-HQ) was introduced and a data inputting and analysis calculator was developed following a consensus group exercise with the clinical and operational leads of MSK physiotherapy teams to facilitate the implementation of the MSK-HQ.

The effects of a new Tendo-Achilles Pathway (TAP) on an orthopaedic department.

Achilles tendinopathy is a common pathology that is considered difficult to treat. At a time of austerity in the NHS it is essential to have carefully designed pathways that are monitored in terms of cost and effectiveness. However, a paucity of evidence exists for what the “best value” dedicated “joined up” pathway of care is for this difficult condition. Design, implement and evaluate the impact of a new therapist lead pathway for Tendon- Achilles Pain (TAP).