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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The role of Men's Sheds in promoting the physical and mental well-being of older men.

The active and healthy ageing agenda challenges the perception that old age is a negative experience and recognises the positive contributions that older adults can make to their communities. However, successful ageing in place requires community-based support for older adults that facilitates social participation, independence and being active. Older men are less likely to join community groups where they can develop social ties and less gender specific support services are available for them.

Men's Sheds (MiS) is an initiative that aims to mitigate this by fostering the building of social networks between older men by providing social space for them to meet and undertake physical activities such as woodwork or metalwork.

The purpose of this research is to investigate the impact of MiS on the physical health and mental well-being of the attendees.

Description of performance and functional trajectory of acute oncology inpatients at a London tertiary centre.

Advances in cancer care and its treatment mean that people living with a cancer diagnosis are living longer but not necessarily living well. It is reported that cancer patients present with multifaceted symptom burden that often impacts on physical performance.

At present exemplar models of cancer rehabilitation exist across the UK along with tumour and symptoms rehabilitation guidance in the form of NCAT Rehabilitation Pathways (National Cancer Action Team, Macmillian Cancer Support 2013). Implementation of these rehabilitation pathways into the inpatient setting can be challenging due to the multifactorial nature and interplay of symptoms cancer patients present with and the resources available.

Our local study primarily aimed to understand the functional trajectory of our acute inpatient population in order to determine how the cancer rehabilitation of the acute population can be optimised in future proposed work.

Key study aims:

  • To describe the acute inpatient oncology population
  • To describe the performance and functional trajectory of the acute inpatient oncology population
  • To feed into a wider project supported by fit for the future looking at “how do we optimise rehabilitation in acute oncology inpatients”

A project evaluating integration of a physiotherapy assistant practitioner into consultant led falls clinic and the effect on referrals.

72% of Community Rehabilitation Team (CRT) referrals are generated outside of our NHS Trust. External referrers have no access to our electronic records, and the complexity of local therapy services mean that duplicate and repeat referrals are common. Previous work also highlighted the 'yes' effect of individuals attending outpatient clinics, who consented to onward CRT referrals, but subsequently declined intervention.

This 'Plan, Do, Study, Act' (PDSA) project aimed to evaluate a new way of working to manage both issues. The project was undertaken in a neighbouring trust Consultant Led Falls Clinic (CLFC), identified as high referrer to our service.

The Active Back Programme - A model for multidisciplinary persistent lower back pain rehabilitation.

The RNOH Active Back Programme (ABP) is a residential multi-disciplinary rehabilitation programme for people with persistent lower back pain. The aims of the ABP are to decrease the effects of pain on lifestyle by facilitating behavioural change through building self-efficacy and confidence. The long term goal is to reduce healthcare utilisation and hence the economic burden of back pain. Recent emerging evidence has highlighted the importance of targeting patient-specific fear avoidance. This shift in approach has significantly impacted the outcomes that therapy can achieve in terms of pain reduction and disability.

The purpose of this evaluation was to gauge the short-term outcomes at three months following completion of the ABP using measures of self-efficacy, confidence and physical capacity.

Increasing long-term participation in sports based activities in children and young people with acquired brain injury.

Participation in sports can play a key role in a child’s quality of life, development and learning (Willis, 2018). Children and young people (CYP) with acquired brain injury (ABI) face significant barriers in accessing sporting and leisure activities.  This reduces the likelihood of participation in regular sporting and leisure activities (Anaby,2018),  both in the recovery period and the later stages (Willis, 2018).

This is a quality improvement project that explores the implementation of a sports based group in a neurorehabilitation centre for CYP with ABI.

Metastatic Spinal Cord Compression - A Retrospective Audit of Current Practice on Medical Oncology and Haematology Wards at GSTT

Metastatic spinal cord compression (MSCC) is an oncological emergency that requires efficient and effective diagnosis, treatment and rehabilitation (NICE 2008).

 

The current MSCC quality standards for adults highlight the need for:

  • Early detection of MSCC through appropriate assessment by MSCC Co-ordinator, spinal surgeon and clinical oncologist, and imaging within 24 hours.
  • Treatment (dexamethasone, radiotherapy, surgery) commencement within 24 hours of confirmed diagnosis
  • Timely rehabilitation and discharge planning with patient and family input

 

The aim of this audit is to:

  • Determine whether the multidisciplinary team (MDT) management of MSCC patients meets national (NICE 2008) and local (KHP, 2016) guidelines at Guys and St Thomas Foundation Trust (GSTT)
  • To identify if and where improvements need to be made against both national and local guidance.
  • To assess components of the care pathway for timeliness, clinical decisions and processes – namely referrals to clinical oncologists, neuro/spinal surgeon, access to timely imaging, prescribing a suitable dexamethasone dose, timely treatment decisions, confirming spinal stability status and referral to rehabilitation services with provision of timely rehabilitation.

Maximising impact of gait analysis reports on non-surgical management of children with neurodisability.

Instrumented gait analysis (IGA) impacts clinical decision-making in orthopaedic management planning for ambulant children with neurodisability (CwND). Studies shown that IGA influences paediatric surgery planning, but clarity on paediatric physiotherapy practice impact is sparse. Physiotherapists play an important role in helping ambulant CwND fulfil functional potential through management of walking ability, gait improvement training, equipment and post-operative gait rehabilitation but possibly under-use IGA. The study aim was to improve utilisation of IGA reports in inter-disciplinary management of CwND.