Innovations

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Innovations

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 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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Standardising physiotherapy provision for patients with haemophilia

Haemophilia is an inherited bleeding disorder characterized by recurrent bleeding into muscles and joints with longer term effects including synovial hypertrophy and destruction of the articular cartilage. The national service specification for haemophilia states that 'specialist physiotherapists trained in line with the Haemophilia Chartered Physiotherapists Association' (HCPA) should be a part of haemophilia services. Despite this, there is huge variability in funded, protected hours for physiotherapists working in this area across the UK. Implications of inadequate physiotherapy provision for these patients is far reaching, including increased bleeds and subsequent joint damage for patients, increased factor costs, and increased pressure on haemophilia doctors. One of the key objectives of the HCPA is to establish core principles of care, determine the levels of service provision and improve physiotherapy services for people with haemophilia in the UK.

Oxygen and Non-Invasive Ventilation Pathways in an Adult Cystic Fibrosis Centre

Cystic Fibrosis (CF) is a genetically inherited condition affecting more than 10,000 people in the United Kingdom. A progressive cycle of infection and lung damage occurs. Worsening lung function results in hypoventilation and ultimately leads to respiratory failure that may require supplementary oxygen and/or mechanical support such as Non-Invasive Ventilation (NIV). Guidelines support the use of NIV for nocturnal hypoventilation, hypercapnic respiratory failure and as a bridge to transplant. At the time of development, there were no published guidelines on the use of oxygen therapy in CF and no published pathways on the set up and management of supplementary oxygen or NIV in CF. This special interest report documents the development of separate oxygen and NIV pathways through interdisciplinary working in an adult CF centre.

Objective To develop pathways for supplementary oxygen and the set up and management of NIV in an adult CF centre.

Trial of diagnostic ultrasound in the orthopaedic setting

Historically, provision of MSK Ultrasound diagnostics has been via a referral to Radiology. However, there is increasing evidence that assessment, investigation and initiating treatment at the initial appointment is shown to be cost-effective, increasing patient satisfaction. Utilising this approach also reduces repeated hospital visits for further diagnostics and appointment times for results. The aim of using Point of Care (POC) ultrasound is to enhance the patient experience through instant access to diagnosis, timely implementation of most appropriate clinical pathway and achievement of the optimal outcome in the shortest possible time.

This study aims to investigate the benefits of point of care (POC) and schedule ultrasound clinics using a proof of concepts approach in the orthopaedic setting.

Use of a patient reported outcome measure with acute adult in-patients receiving physiotherapy

The use of outcome measures is well evidenced and documented. Despite prevalent use of various clinician reported outcome measures (CROMs), patient reported outcome measures (PROMs) are often in the form of detailed quality of life questionnaires, which are not appropriate in acute, fast paced environments. A new PROM tool (called thera-PROM) was devised and used with the aim of measuring the effect of goal-focused physiotherapy interventions in an acute adult in-patient setting. Process and data evaluation aims to identify standards and guidelines for future use to support service evaluation and quality measurement.

The small scale project was carried out as a starter to implement an appropriate PROM tool for the clinical area where there was not previously any PROM tool used as it had not been possible to identify an existing PROM tool that was fit for purpose.  The findings may be useful to share with other therapists for wider use or consideration when implementing a PROM tool.

The East Lothian Discharge to Assess Service

Unnecessary delay in discharging patients from hospital is a systemic problem with a rising trend. In 2016/17 there were 532,423 bed days occupied by medically fit patients in Scotland. Over 70% were aged over 75. Current evidence highlights correlation between longer hospital stays and potential harm, resulting in poorer health outcomes, an increase in long-term care needs, poor patient flow and avoidable use of acute resources. Discharge to Assess (D2A) is a national driver and within East Lothian we looked to develop a pathway that supports discharging patients that are clinically fit and appropriate to have their Physiotherapy/Occupational Therapy assessments at home. We aimed to embed D2A as a core East Lothian service and promote a culture of 'ownership' of East Lothian patients throughout their patient journey.

Implementing an occupational healthcare model

Approximately 20,000 sick days (1500 staff members) at St. George's University Hospitals NHS Trust (SGUHT) are due to musculoskeletal issues. This costs the trust approximately £3.4 million per year. Despite this it is the only trust within inner London that, currently, does not have a physiotherapy service within their Occupational Health (OH) offering. The argument for delivering the service is clear, supported by previous research, service evaluations and local data analysis.