Utilising Therapy Services Differently in an
Acute Hospital Setting
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Aims
• To give an overview of how we have
implemented changes in therapy referral
and delivery in an acute hospital within
current budget
• To feedback the perceived staff and
patient benefits from the first three
months of implementation
• To discuss the ongoing and further
development of the initiative
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Introduction
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Background
Issues identified
Implementing changes
Progress
Challenges for therapists
• Points for discussion
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Background
• Recent change in management
structure within therapies
• Assurance visit from ECIST May
2012
• Withdrawal of ICRT from acute
medical unit (AMU)
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Issues Identified
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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 how
community services are commissioned
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Implementing Changes
Change Process:• Therapies workshop for Occupational
Therapist’s (OTs) and Physio’s-June
2012
• Four workstreams identified, one of
which was tasked to look at referral
process and working in speciality teams
rather than ward based teams
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Implementing Changes
What we did:• Older Adults Therapy team started to case
find patients in AMU from July 2012
• Other therapy teams started to work in
specialty rather than ward based
• The team carrying out the initial assessment
followed the patient throughout their hospital
stay
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Progress
Perceived Patient Benefits:• Continuity of therapy provision throughout their
hospital stay
• Prevention of institutionalisation and deterioration
in function whilst in hospital as patients have
therapy plans from the point of admission
• Reduction in duplication of therapy assessments
• Therapy discharge is planned from the point of
admission rather than on referral
Christina Richards, Anne McLaughlin,N ichola Higginson Oct 2012
Progress
Benefits to Staff:•
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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 working
relationships
• 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 robust
data collection
• Establishing further multi-disciplinary working
including specialist nurse and AMU
consultant with special interest in older adults
• Trialling a 6 day working pattern for OT’s and
weekend assistant list
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Challenges to therapists
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Staff morale
Threat of generic working
Changes to healthcare provision
Understanding the risks to the profession if
change is not embraced
Christina Richards, Anne McLaughlin, Nichola Higginson Oct 2012
Points for Discussion
• How do you develop flexible and supportive
cross professional working?
• How do you engage therapy staff in
organisational change?
• How and when do therapists engage in the
discharge 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 Middlesex
UniversityHospital
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