Innovations

1) To identify variations from NICE MSCC guidelines in the MSK pathway for patients regarding timelines from early detection and time to MRI 2) To use this clinical audit data to inform clinical commissioning groups (CCGs) and local hospital providers about access of referral

Time: Ours to organise, ours to spend and equally ours to waste- but what about when that control is taken. In a culture where our days are filled with loved ones, work and activity, we choose to balance our time across these. However, when you are admitted to an acute hospital, this aspect of choice is often taken away.

As physiotherapists one of our key roles in inpatient care is to improve and regain function to allow our patients to return to their home at their baseline level. By making simple changes- getting patients dressed into day clothes, walking to the toilet and sitting in a chair for meals there can be a clear correlation with the speed of a patient's rehabilitation.

Physiotherapy programmes must prepare graduates to live and work in a globally interconnected society. Internationalised learning experiences have the potential to break down ethnocentric worldviews by exposing students to analysis and critique of practice from different cultural perspectives. Such experiences may enable transformative learning by developing the student's ability to shift perspective and reflect critically on how disciplinary practice can change with the social context. Opportunities to study abroad can only be offered to a minority of students. In contrast, digital technology such as discussion forums and video conferencing provide an inclusive platform to make international experiences available to all students on a programme. The aim of this educational project was to engage physiotherapy students in a transnational collaborative group task in order to increase awareness of different international perspectives on clinical practice and healthcare provision and facilitate reflection on their local context.

The purpose of the audit is to gain a detailed understanding of the physiotherapy management of patients with hip fracture, so that recommendations can be made which will result in improvements. By using a standardised national audit tool, data and information will enable physiotherapists to understand how to improve both the service delivery and the experience of physiotherapy for hip fracture patients. This audit will also demonstrate to external stakeholders the professions readiness to embrace the findings from the audit, in order to make improvements

'Advancing Quality' (AQ) was launched in 2008 across all hospitals in the north west of England with the aim of improving patient outcomes and reducing costs (Advancing Quality Alliance 2016). In 2015 the management of hip fracture was added as a key clinical area for evaluation/improvement, and included the measure: 'HFR-07 - Physiotherapy assessment within 24 hours of surgery'. Our Trust audit department therefore started producing monthly data for AQ hip fracture targets, which initially revealed our compliance with the above physiotherapy measure to be at 78% (target set at 100%). The purpose of this project was therefore to improve the achievement of this measure. A Plan-Do-Study-Act (PDSA) service improvement approach was chosen - as initially described by Deming (1986), and then later adapted specifically for use in healthcare by Langley et. al. (1996).

The use of diagnostic thoracic ultrasound (TUS) by physiotherapists to examine the pleura, lung parenchyma and diaphragm is gaining in popularity. In the medical profession it has been shown to have efficacy in the diagnosis of pulmonary conditions such as pneumonia, pleural effusions and diaphragm dysfunction. It is unclear how effective TUS is in the hands of a physiotherapist. The aim of this scoping review is to explore the emerging evidence surrounding physiotherapy use of TUS to inform research and clinical practice.  

To demonstrate how a specialist respiratory physiotherapy service placed in the community can prevent unnecessary hospital admissions in patients with COPD.

This project is an example of multiprofessional working that provides a safe service for patients whilst making cost savings. 

The new service was established in 2011 to manage Home Oxygen across Grampian. The multi-professional team provides all home oxygen (except for paediatric and cluster headache) based on a clinical need and risk management approach, and liaises with secondary and primary care. The revised service has demonstrated monthly cost improvements of £15 – 20k per month.

A web based prescribing system has been introduced this year by the contractor which offers easy access to updated information relating to individual patients use of oxygen.

I wanted to highlight the cost savings gained following a review and change of service delivery to children with focal spasticity in a district general hospital.  The purpose of the review and change was to improve the service we provided to children and their families in terms of timeliness on intervention, proximity to home and follow-up with known clinicians. 

Although the data is from 2014, we continue to inject less that 10% of our children under a general anaesthetic compared to 78% in 2009.

This service is led and delivered by a physiotherapist working in an extended role – initially Clinical Specialist, now Advanced Physiotherapy Practitioner with support from Orthopaedic and Neurology consultants.