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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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Integrated Care of Older People (iCOP): A Service Delivering Comprehensive Geriatric Assessment on the Acute Assessment Unit at Singleton Hospital

The Integrated Care of Older People ( iCOP) service is a fully integrated Multidisciplinary team that supports older people living with frailty. The demographic characteristics of this population commands a model of care tailored to the needs of people living with frailty attending Swansea's Singleton Hospital Assessment Unit (SAU). The original model did not deliver the high quality, integrated, person centred care that older people require.

There are guidelines for the identification and management of frailty in the acute setting. These are set out in the British Geriatric Society (BGS) “Fit for Frailty” document. Comprehensive geriatric assessment is identified as the gold standard for assessing older people living with frailty and leads to better outcomes for patients.

Following a successful pilot within SAU Singleton Delivery Unit during 2017, a business case was prepared and delivered to the Executive team of ABMU. Funding was granted, allowing the service to become embedded as a sustainable acute frailty service. The iCOP team will deliver Comprehensive Geriatric Assessment (CGA) for 40% of the medical intake aged >75, to include people with frailty syndromes, such as, falls, confusion, dementia and immobility. The aim is to increase the percentage of discharges directly from SAU, thus facilitating admission avoidance, and reduced length of stay.

Talkback: A co-designed educational resource for people with lower back pain

NICE recommends that people with back pain are provided with advice and information tailored to their needs and capabilities. However implementation of research evidence/guidelines into practice is not always successful.

Co-production using creative co-design methods offers a different approach to intervention development. It aims to produce, with all relevant stakeholders, contextually sensitive solutions that are more likely to be acceptable and implementable into practice.

This project aimed to co-design an educational resource for people with low back that would specifically facilitate positive thinking and behaviours to support their physiotherapy management.

Identifying the Physiotherapy and Occupational therapy service provision for patients admitted with neurological conditions- are we coordinating care?

During an acute admission early assessment and treatment provided by the Multi-Disciplinary Team (MDT) is a requirement of the National service frame work for long term conditions.

Within our large London teaching hospital, we were aware that patients admitted who had a long term neurological condition, other than stroke, were not being treated with an integrated MDT approach.

We were concerned that patients' needs weren't being best met in a timely way, joint goal setting was not happening and discharge planning might not be optimised. However, we had limited data to support these observations as patients were dispersed throughout the hospital.

Integration of primary and secondary care stroke rehabilitation into one continuous MDT pathway.

To modernise segregated stroke rehabilitation teams working along a care pathway in line with current NHS strategic planning and best practice. Commissioner restructuring for Stroke Care in Rotherham NHS Foundation Trust amalgamated multi-disciplinary care teams from primary and secondary care.

The new service was designed to allow staff to journey with their patients from entering to completion of the pathway. The preceding and updated services were evaluated using pre-existing quantitative and qualitative measures.

The effectiveness of Extracorporeal shock wave therapy (ESWT) in the treatment of lower limb conditions- a pilot Clinical Audit.

To investigate the use of ESWT in advanced practitioner clinics for lower limb conditions (tendinopathies).

The orthopaedic department procured an ESWT machine for use in orthopaedic clinics. This lead to a project aimed at setting up a package of care for treating lower limb conditions. It involved the utilisation of AHP's in orthopaedic clinic to manage this difficult group of patients in an orthopaedic setting.

An Evaluation of Emergency Department Patients Referred for Urgent Lumbar Magnetic Resonance Imaging with Suspected Cauda Equina Syndrome.

Failing to correctly diagnose Cauda Equina Syndrome (CES) in the Emergency Department (ED) can have catastrophic consequences for the patient and be costly for the National Health Service (NHS). The ED clinician bears a weight of responsibility in the decision to refer for urgent Magnetic Resonance Imaging (MRI) in the presence of a plethora of potentially inconsistent Red Flags, whilst being mindful of limited MRI scanning resources.

The purpose of this study was to calculate the number of cases of suspected CES referred from the ED of a large teaching hospital for urgent MRI scanning over a six month period and to determine the percentage of positive diagnoses.

The secondary objective was to evaluate and compare the signs and symptoms of all suspected cases of CES.