North West

Audit of a dedicated scaphoid pathway

To evaluate the implementation of a service redesign for patients with suspected scaphoid fractures. A scaphoid fracture is a diagnostic and radiographic challenge for clinicians with heterogeneity of assessment and treatment nationally. We propose an advanced physiotherapy led model that reduces both direct and indirect costs to the patient, trust and NHS that is shown to be safe and effective.

Patients presenting with back pain and history of cancer

Metastatic spinal cord compression (MSCC) is a well-recognised complication of cancer. The National Institute of Clinical Excellence (NICE) provided clinical guidelines regarding assessment and management of patients with back pain and cancer history with suspected spinal cord compression; NICE CG-75. This study aims to determine if patients are managed appropriately and in a timely manner, according to these guidelines.

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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