The impact an in-house rotational paediatric physiotherapist has on the management of children and young adults in a hospice setting.

Purpose

To identify the benefits and implications to staff and service users of having an acutely trained rotational physiotherapist in a community hospice setting for children and young adults with complex health needs.  

Staff feedback from questionnaires demonstrated that 100%
felt that having a physiotherapist in post was beneficial.
100% of attendees found that the postural care study day was beneficial
and 100% would recommend it to a colleague.

Approach

Qualitative data collection over a 9 month period in the form of questionnaires as feedback forms from staff and parents/ guardians of service users or where appropriate service users themselves.

Outcomes

Staff feedback from questionnaires demonstrated that 100% felt that having a physiotherapist in post was beneficial. 100% of attendees found that the postural care study day was beneficial and 100% would recommend it to a colleague. We have also received positive feedback and comments from parents of service users. However, it was also identified from staff feedback that there are areas of self reported weakness and lack of confidence to carry out limb therapy and airway clearance techniques for these complex children. Staff have also reported an increase in confidence since a physiotherapist has been in post with more of these programmes being carried out.  

We have received positive feedback on the role of a rotational physiotherapist at Naomi House and Jacksplace so far. The staff feedback questionnaires identified areas of weakness and poor confidence and has provided us with an opportunity to implement a weekly session specifically for therapy jointly with carers on the care floor. This feedback has shown the benefits to staff and service users of having an acute rotational Physiotherapist in a hospice setting for children and young adults with increasingly complex needs. To our knowledge this is a unique set up.

Cost and savings

There were no cost implications in this study, it was carried out as a service evaluation of a new role with the intention to replicate this going forward to develop the unique role. 

Implications

We hope to continue to collect data about this service from hospice staff to review their abilities to maintain their competencies and confidence in managing children and young people with increasingly complex needs. There is also potential for further data collection on the impact of the role on self reported quality of life from the service users of Jacksplace.

It has been identified that there is a lack of formal research in this field and this is something that we hope to contribute to in the future with our unique set up. We will aim to continue to build stronger links with UHS as the role progresses and as new therapists rotate into the role from the tertiary centre further links, changes and innovation will continue. We hope that other similar centres could benefit from our experience in this area.

Top three learning points

  1. As the therapist was new to the hospice when carrying out the service evaluation there may not have been as high a return rate on questionnaires as liked. Once the role is more established hopefully this will improve.
  2. It identified to us areas of learning/teaching that was felt to be required by the staff at the hospice to help to support them with their role in supporting children and young people with routine physiotherapy care and interventions.
  3. There is a lack of formal research in this area and it may be beneficial for us to contribute to this going forward as the role develops.

Fund acknowledgements

This work was unfunded

Additional notes

This work was presented at Physiotherapy UK 2019.