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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Redesign of NHS Forth Valley´s Community Rehabilitation AHP Single Point of Referral.

NHS Forth Valley Community AHP services have redesigned how they deal with referrals received into their services. Until recently, point of receipt of referrals was purely administrative, with staff signposting to various parts of service that are delivered. Referrals that were deemed “inappropriate” were often lost in the system; there was no cognisance of how these “inappropriate” referrals should be dealt with. There was no understanding of time spent dealing with these queries. We redesigned the service, 'going live' in November 2018, to bring clinical staff into SPR, triaging the referrals received using a Personal Outcomes Approach and have reduced the number of referrals going forwards for intervention at the rehab teams, and increased signposting and self management in the community. This has had a knock on effect to reducing waiting times and enabled a more specific and tailored approach to those requiring rehabilitation in the community.

What is the patient experience of a functional goal orientated back group?

Chronic low back pain causes a significant physical, psychological and financial burden to a wide variety of the population and health care services.

Despite a large field of research, optimum long term management remains unknown. The NICE guidelines recommend group exercise for the management of low back pain.

Recently, functional rehabilitation including the restoration of normal movement patterns has gained increasing evidence in the literature. However, there is limited research outlining the effectiveness of a combined approach, involving functional rehabilitation in a group setting.

The aim of this study was to understand the patient experience of a functional goal orientated back group in a South Yorkshire NHS secondary care hospital

A 3 month prospective audit of physiotherapy referrals to a Community Rehabilitation Team and trial of alternative triage process.

The Community Rehabilitation Team (CRT) provides intermediate care and rehabilitation to individuals unable to leave their homes or who do not meet referral criteria for specialist services. Therapists are generalists whose specialism is managing complexity.

Current practice required all clinical staff (B4 and above) to triage referrals for suitability, and to assign appropriate referrals to immediate action (within 5 days) or a waiting list (up to 18 weeks), according to clinical need. This decision was commonly made directly from information contained within the referral.  

Staff expressed anxiety and frustration with the process, and an inability to affect change or provide support to colleagues. Referrals from traditionally hierarchical superiors could be challenging, especially when declining inappropriate referrals, with concern that this may affect future commissioning.  

This audit of physiotherapy referrals, aimed to classify our caseload through collection of quantitative data, and to trial an alternative triage process.

A Rapid Review of evidence for management of patients that frequently attend Emergency Departments with Chronic Pain.

Frequent attenders (FA) (defined as individuals that attend more than 5 times per annum) of ED have been reported to account for 13% of the total cohort. A common reason for presentation is chronic pain. Guidelines recommended that Frequent Attenders are identified, that case management may assist with involving other services and that multidisciplinary case conferences may aid patient engagement.

  • To critique evidence for case management of patients that frequently attend ED with chronic pain.
  • To utilise the evidence to support an innovative rapid access pathway to a pain rehabilitation service.

NICE Guidance and Quality Standard Assurance Evaluation: a process redesign to improve effectiveness and efficiency.

NICE assurances processes which evaluate local clinical practice and services against NICE guidance, quality standards and interventions are important clinical effectiveness and quality improvement strategies. Trusts are required to undertake a local NICE assurance process and results of evaluations are reported centrally.

The aim of this project was to develop a more efficient, robust and meaningful approach to our NICE assurance process across our complex, multi-professional clinical division. Our division has over 30 different clinical services in acute and community settings across East Sussex. The objective was to create a single, unified and responsive approach across all our uni- and multi-professional services.

Improving access to Paediatric Physiotherapy services within a community team - Physiotherapy drop-in screening service

The purpose of establishing the physiotherapy drop in service was:

  1. To improve the appropriateness of referrals being sent to the Physiotherapy department
  2. To provide a universal Paediatric Physiotherapy screening service within the borough for all children and young people
  3. To signpost Children and Young People to the required services or provide information and advice where appropriate

The above purpose links with the aims of the universal service provided by the Physiotherapy department which include: To improve education within the borough about normal development, create free opportunities to develop gross motor skills and educate parents ensuring carryover to the home environment, to highlight the contribution that Physiotherapy can make to the prevention of illness and the promotion of good health through encouraging appropriate physical activity.

The effectiveness of hip strengthening exercises in the management of patellofemoral pain syndrome (PFPS) in females.

Patellofemoral pain syndrome (PFPS) is a common and often chronic knee condition with a high prevalence in females of working age. The regular presence of hip weakness in female patients with PFPS, has led to research emerging on hip strengthening exercises.

The aim of the systematic review was to examine the effectiveness of hip specific strengthening exercises on the management of patellofemoral pain syndrome (PFPS) specifically in females.

Secondly, to evaluate whether hip strengthening exercises should be identified as a primary treatment choice for managing PFPS in females.