Innovations

The National Hip Fracture Database (NHFD) publishes performance data which includes achievement of early post-operative mobility - defined as 'Mobilised on day of, or day following, surgery'.

It had been anecdotally noted on our Orthopaedic trauma unit that patients who experience a delay to surgery find it more difficult to achieve this early mobility target (with 'delay' to surgery defined here as failure to meet the NICE clinical guideline for hip fracture: 'Perform surgery on the day of, or the day after, admission').

This study therefore aimed to objectively investigate this supposition.

This study aims to identify Physiotherapist's perceptions and experiences of Telephone Triage, as well as identifying any barriers they may face when triaging.

Professional barriers to PTT have been suggested demonstrating clinician reluctance despite patient satisfaction. Little is known about the effect of the role change on the Physiotherapist, and the inability to physically examine the patient.

This research will help direct training and the working experience for Physiotherapists, improve current Triage structures and provide justification to organisations implementing the service. Understanding barriers to PTT will assist with service planning and change management.

To ascertain whether the inclusion of very early exercise post-COPD exacerbation via the addition of a full-time technician to the COPD Team improves patient outcomes, experience and healthcare related costs above and beyond outcomes already achieved by the existing service.

In addition, to reduce barriers to participation in physical activity and pulmonary rehabilitation attendance commonly observed within this patient group, including being housebound, transport difficulties, geographical inequality in service provision, carer responsibilities, disease severity and high levels of physical and mental comorbidity. Currently inactivity, activity avoidance owing to anxiety regarding dyspnoea and a poor uptake and/ or completion of pulmonary rehabilitation are demonstrated within this cohort of patients, who often have severe disease, which is advocated as a key management strategy nationally and internationally for COPD .

The purpose of this service change is to facilitate other options in assisting patients to achieve better outcomes and an enhanced quality of life through early exercise in conjunction with pre-existing self-management support.

Stroke and brain injury-survivors have difficulty controlling muscles and in many cases, 'tightness' of muscles called spasticity. Spasticity is often painful, akin to muscle-cramp. It can limit mobility and independence and cause distressing complications of contractures, skin breakdown and pressure sores.

The aim of this work was to development a preliminary model 'goal-Directed and person-centred Rehabilitation (Direct-Rehab)', to link clinical decision making for patient centred treatment, with the goals and process of treatment. This requires a focus on linking physical rehabilitation treatments (often in combination with pharmacological treatments such as botulinum toxin) to person-centred goals.

To identify most common barriers to decannulation in complex neurosurgical patients and explore therapy options to overcome these and reduce time with tracheostomy in situ.

Obesity is a growing problem in the UK affecting all areas of the NHS, with over a quarter of all adults falling into this category. The additional risks and co-mobidities that obesity is linked with leads to a high number of hospital admissions.

The multidisciplinary teams working with these people require appropriate knowledge and skills to deliver safe and effective care, with the National Institute for Health and Care Excellence (2014) recommending that staff be appropriately trained to use specialist equipment when working with this complex group of people.

Research has shown that interprofessional team working can play an important part in improving patient safety. This report details the process an interprofessional team have undertaken to develop a simulated bariatric scenario as part of the learning materials that complement practical moving and handling sessions for undergraduate students.

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.

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”

To increase understanding of the occurrence and evolution of physical and postural disability affecting adults who remain in a prolonged disorder of consciousness, to better inform their long term health care provision.

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.