Innovations

Traditionally the Electrical Stimulation (ES) of muscles was a frequently used adjunct for rehabilitation following nerve injury. More recently its use has been in decline. An international collaborative group of therapists with a special interest in Traumatic Brachial Plexus Injuries (TBPI) was formed in 2017. One of the objectives of the group is to assess and improve the evidence base surrounding the rehabilitation of TBPI. Disparity within the group with regards to the use of ES highlighted the need to explore current practice and the reasons for variability in use.

Advancement in healthcare has led to people living longer. This has made older adults' care become a concern in the United Kingdom. There is added pressure on hospitals, social services and the government in the human and financial resources needed for their care. County councils are using reablement which focuses on relearning skills for independence to reduce older adults' care cost. This study focused on evaluating the reablement of older adults in a centre in the north of England for areas of improvement. The centre helps facilitate discharges from hospitals. The evaluation became necessary due to the recurrent admissions of some clients. It was also important to know the perceptions of the recipients of reablement to incorporate in improvement of the service.

The purpose of the study was to find out the perceptions of older adults 65 years and over admitted in a specialist care centre about the reablement provided to increase their independence to return home.

Metastatic spinal cord compression (MSCC) is a well-recognised complication of cancer. The National Institute of Clinical Excellence (NICE) provided clinical guidelines regarding assessment and management of patients with back pain and cancer history with suspected spinal cord compression; NICE CG-75. This study aims to determine if patients are managed appropriately and in a timely manner, according to these guidelines.

Adults with long-term neurological conditions have low levels of participation in physical activities and report many barriers to exercise. This study used a mixed methods approach to evaluate participant experiences and outcomes following participation in student-led, community-based neurological groups and to explore the feasibility of performing a full-scale study.

To evaluate whether service improvements could be made to our community physiotherapy service through clinical streaming of patient referrals using underlying principles complexity science to consistently deploy the most appropriate member of the physiotherapy team to meet the needs of patients and improve the effectiveness of our service.

An audit on length of stay (LOS) for total knee replacement (TKR) patients following surgery highlighted that a number of patients were exceeding their predicted date of discharge (PDD), many due to not achieving traditional physiotherapy goals (90⁰ flexion, < 5 ° extension lack and good quadriceps function), despite being safely mobile and medically fit. This exposes patients to risk of harm due to prolonged stay within an acute hospital environment as well as inefficient utilisation of an in-patient bed. A Physiotherapy Supported Discharge Service (PSDS) had previously been piloted for six months. Phase 2 consisted of permanent service resign, continuing the PSDS and service evaluation.

It was recognised that the neuro-rehabilitation unit had a length of stay above the national average of 80 days. A new multidisciplinary goal planning process was implemented on the unit with the following aims; reduce length of stay to the national average; reduce the waiting list to 1 week; to consistently achieve greater than 70% patient and family/carer satisfaction.  The impact on the FIM/FAM outcome measure was monitored to ensure there were no adverse effects on patient outcome as a result of implementing the new process.

Oxford Health NHS Foundation Trust (OHFT) committed to a Stroke Quality Improvement (QI) Project to enhance the quality of rehabilitation for patients on the Oxfordshire Stroke Pathway. Following poor performance in the national indicators Sentinel Stroke National Audit Program (SSNAP) and local Key Performance Indicators (KPIs), the Stroke Quality meeting was initiated by the physiotherapy team to review care and develop a multi-professional improvement plan. Aligning service provision with that recommended in the 2016 Royal College of Physicians National Stroke Guidelines required consolidation of two stroke units, 14 miles apart, into one specialist stroke rehabilitation ward. This abstract outlines key objectives of the QI project, describe progress to date, and evaluates the impact on quality delivery and patient outcomes so far. The objective is to share positive experiences and challenges encountered during the project.

To describe a musculoskeletal (MSK) physiotherapist's clinical academic journey involving the unique elements of design and creative practice, focusing on knowledge mobilisation and implementation in line with research capacity building for, within and by practice.

A service for clients with MND was developed over the past 5 years within VCRS to allow this group of service users easy access to the multidisciplinary team (MDT) throughout the duration of their illness.

We are interested in improving the coordination, communication and care of patients with MND, from diagnosis to end of life, supported by NICE (2016) and MNDA guidelines. We developed individual speciality pathways to encourage prudent healthcare and bridged links in service provision to reduce individual therapy visits, duplication of referrals and assessments and ineffective communication within VCRS and the wider MDT.

The purpose of the service evaluation was to examine if the current service provision actually meets the needs of the service users and their families. We also wanted to identify areas which require further improvement.

We are keen to share this piece of work to demonstrate how existing practices can be altered in order to provide a more prudent and equitable service to this group of clients.