Utilising Therapy Services Differently in anAcute Hospital Setting
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Aims
•To give an overview of how we haveimplemented changes in therapy referraland delivery in an acute hospital withincurrent budget
•To feedback the perceived staff andpatient benefits from the first threemonths of implementation
•To discuss the ongoing and furtherdevelopment of the initiative
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Introduction
•Background
•Issues identified
•Implementing changes
•Progress
•Challenges for therapists
•Points for discussion
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Background
•Recent change in managementstructure within therapies
•Assurance visit from ECIST May2012
•Withdrawal of ICRT from acutemedical unit (AMU)
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Issues Identified
•Continued use of escalation beds
•The “Lost Tribe of Elderly”
•Current working practice of therapists
•AMU referral driven therapy input
•The impact of the change in howcommunity services are commissioned
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Implementing Changes
Change Process:-
•Therapies workshop for OccupationalTherapist’s (OTs) and Physio’s-June2012
•Four workstreams identified, one ofwhich was tasked to look at referralprocess and working in speciality teamsrather than ward based teams
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Implementing Changes
What we did:-
•Older Adults Therapy team started to casefind patients in AMU from July 2012
•Other therapy teams started to work inspecialty rather than ward based
•The team carrying out the initial assessmentfollowed the patient throughout their hospitalstay
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Progress
Perceived Patient Benefits:-
•Continuity of therapy provision throughout theirhospital stay
•Prevention of institutionalisation and deteriorationin function whilst in hospital as patients havetherapy plans from the point of admission
•Reduction in duplication of therapy assessments
•Therapy discharge is planned from the point ofadmission rather than on referral
Christina Richards, Anne McLaughlin,N ichola Higginson Oct 2012
Progress
Benefits to Staff:-
•Increased job satisfaction
•Feeling valued
•Decreased stress
•Caseload continuity
•Raised therapy profile
Christina Richards, Anne McLaughlin,N ichola Higginson Oct 2012
Progress
•What made it work:-
•Good cross professional workingrelationships
•Good skill mix
•Staff engagement
•Management support
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Progress
Where are we going from here?
•Links with local university to ensure robustdata collection
•Establishing further multi-disciplinary workingincluding specialist nurse and AMUconsultant with special interest in older adults
•Trialling a 6 day working pattern for OT’s andweekend assistant list
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Challenges to therapists
•Staff morale
•Threat of generic working
•Changes to healthcare provision
•Understanding the risks to the profession ifchange is not embraced
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Points for Discussion
•How do you develop flexible and supportivecross professional working?
•How do you engage therapy staff inorganisational change?
•How and when do therapists engage in thedischarge planning process?
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Contact Details
•Christina Richards- Head of Therapies, West MiddlesexUniversityHospital
Christina.Richards@wmuh.nhs.uk
• Anne Mclaughlin-Older Adults Therapy Service Lead
Anne.Mclaughlin@wmuh.nhs.uk
•Nikki Higginson- Senior OT, Older Adults Therapy Service
Nichola.Higginson@wmuh.nhs.uk