Patient experience of physiotherapy input on a specialist heart unit

Purpose

Acute heart failure care is recommended to be delivered by a multidisciplinary team, incorporating education, and advocating self-management and patient centred care. With this in mind in 2016 a specialist 11 bedded heart failure unit (HFU) was opened to cohort patients with acute heart failure with the aim of improving outcomes in quality of life, 30 day readmission rates, and mortality. As heart failure is often associated with marked reductions in quality of life and high levels of debility, a full time specialist physiotherapist was funded to work as part of the multidisciplinary specialist team. The aim was to assess the impact of exercise education and early physiotherapy intervention on patient experience.

Approach

Between June 2016 and January 2017, 69 patients completed an anonymous physiotherapy experience survey on discharge from the HFU. The survey was a combination of multiple choice answers as well as having an option to provide written comments. Simple analysis of survey results was completed to evidence patient experience.

Outcomes

Of the patients surveyed, 88% saw a physiotherapist on the heart failure unit. Of those seen (n≈61), 95% felt they had a better understanding of how exercise could help their condition after input by the physiotherapist. 92% felt the physiotherapist respected them at all times, and 87% felt their views were somewhat or completely taken into account by the physiotherapist. 59% of responders reported the physiotherapist set specific goals with them during their stay, with a further 34% unsure. 25% of patients seen by a physiotherapist would not have expected to see a physiotherapist during their stay. 79% of responders felt physiotherapy helped them during their stay, with a further 15% unsure and 3% did not feel physiotherapy helped them. 75% were seen by physiotherapy most days (41%) or every now and then (34%) with only 8% of respondents feeling this was not enough.

Implications

The results indicate physiotherapy input was well received by patients admitted to the HFU. Almost all patients surveyed felt they had a better understating of how exercise could help their condition on discharge. This will assist this patient group to self-manage their condition and improve long term quality of life. Input on the whole was deemed to be helpful and sufficient for patients. The patient group who will benefit most from exercise education are thought to be the higher level patients not previously seen traditionally at this institution who are returning to an active lifestyle after a significant deterioration in their exercise tolerance. An area to move forward with is to set clear patient centred goals to assist with patient motivation. Longer term assessment of quality of life should also be considered along with assessment of long term carryover of knowledge gained and how it has assisted with patient's lifestyle change and self-management.

Physiotherapy intervention is valued by persons of all dependency levels hospitalised with acute heart failure. Commissioning of services in this area should consider physiotherapy.

Top three learning points

  1. Patients are receptive to physiotherapy treatment and education for heart failure.
  2. Physiotherapy input should be considered when commissioning heart failure services.

Fund acknowledgements

This work was unfunded.

Additional notes

This work was presented at Physiotherapy UK 2018.

For further information about his work contact Susan Eriksen