North West

The Network Spinal Cord Compression Service

The incidence of cancer is increasing; people are living longer with better quality of life, however, the risk of developing MSCC remains high for many patients. Prompt diagnosis and treatment is essential to prevent paralysis and failure to recognise the early signs can have devastating implications with the added financial burden of caring for bedbound patients.

All front-line clinicians have a vital role to play in referring suspected MSCC patients into the MSCC service in a timely manner. This includes physiotherapists working in most settings, e.g. MSK, A&E, walk-in centres, community and private sector.

Class format to improve the management of total knee replacement in an out-patient setting

Historically patients at North Manchester General Hospital received traditional 1:1 Physiotherapy treatments post total knee replacement (TKR). Literature suggests a class environment can be more cost effective and yield improved results. Therefore a TKR class was set up in 2015. This summary highlights the findings from the first year demonstrating clinical outcomes, patient satisfaction and cost-effectiveness.

Physiotherapy target measure for hip fracture

'Advancing Quality' (AQ) was launched in 2008 across all hospitals in the north west of England with the aim of improving patient outcomes and reducing costs (Advancing Quality Alliance 2016). In 2015 the management of hip fracture was added as a key clinical area for evaluation/improvement, and included the measure: 'HFR-07 - Physiotherapy assessment within 24 hours of surgery'. Our Trust audit department therefore started producing monthly data for AQ hip fracture targets, which initially revealed our compliance with the above physiotherapy measure to be at 78% (target set at 100%). The purpose of this project was therefore to improve the achievement of this measure. A Plan-Do-Study-Act (PDSA) service improvement approach was chosen - as initially described by Deming (1986), and then later adapted specifically for use in healthcare by Langley et. al. (1996).

Physiotherapy use of thoracic ultrasound

The use of diagnostic thoracic ultrasound (TUS) by physiotherapists to examine the pleura, lung parenchyma and diaphragm is gaining in popularity. In the medical profession it has been shown to have efficacy in the diagnosis of pulmonary conditions such as pneumonia, pleural effusions and diaphragm dysfunction. It is unclear how effective TUS is in the hands of a physiotherapist. The aim of this scoping review is to explore the emerging evidence surrounding physiotherapy use of TUS to inform research and clinical practice.  

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