mary duguid occupational therapist aberdeen royal infirmary
TRANSCRIPT
Mary DuguidOccupational TherapistAberdeen Royal Infirmary
To examine whether iPads can improve the efficiency and communication associated with the discharge of amputees from an acute hospital to their home or community settings.
All new amputees have an environmental home assessment
Information fedback to patient
Actions agreed
Adaptations/equipment or rehousing proceed
Occupational Therapy in TeleRehabilitation - OTTeR
Amputees transferred to care of community therapist
Handover via email or telephone
Transfer techniquesProsthetic components/informationEarly walking aid
Physiotherapy and Occupational Therapy in
TeleRehabilitation - POTTeR
November 2014 – February 2015
iPad with cisco jabber application
“live” link up with patient in hospital and therapist in patients home
“live” multidisciplinary handover with patient to community hospital therapists
Staff and patient experience surveys
Data gathering regarding patient progress on amputee pathway
Live link up for:
• Three environmental home assessments
• Two handoversto community therapists
Occupational Therapy in TeleRehabilitation - OTTeR
Day 9 post amputationVC environmental home assessmentEquipment needs identifiedEquipment ordered
Day 10 Rails delivered
Day 16 Equipment in situ and rails fitted
Day 18Discharged home
Occupational Therapy in TeleRehabilitation - OTTeR
Instant decision making – saved an estimated 3 days which equals £2,319.
Improved patient health score.
Discharged home day 18.
Occupational Therapy in TeleRehabilitation - OTTeR
“It was brilliant it made me feel that my input to the experience was important”
“It made me feel very positive”
“It made me aware of the practicalities required for my release from hospital”
“I was very happy we were able to do things this way”
Occupational Therapy in TeleRehabilitation - OTTeR
Contact with Mr B
Discuss Mr B’s needs
Immediate consent
Hospital OT directly involved
No additional visit
Occupational Therapy in TeleRehabilitation - OTTeR
“Illustrated exactly what therapists talking about” MR C
“Encouraged me, I want to go home, motivates
me to practice my transfers here in hospital” MR C
“Made me realise what changes required (wouldn’t have thought about some changes required” MR E
Occupational Therapy in TeleRehabilitation - OTTeR
Physiotherapy and Occupational Therapy in
TeleRehabilitation - POTTeR
“Done a lot to prepare me” MR D
“Beneficial to meet therapists” MR A
Physiotherapy and Occupational Therapy in
TeleRehabilitation - POTTeR
“Patient centred as patient able to meet therapist before transfer”
COMMUNITY THERAPIST MR D
“Visually see transfer not just have it described” COMMUNITY THERAPIST MR D
“Aware of current abilities and goals” COMMUNITY THERAPIST MR A
“More prepared for seeing patients” COMMUNITY THERAPIST MR A
Physiotherapy and Occupational Therapy in
TeleRehabilitation - POTTeR
“Made transition of care more effective” COMMUNITY THERAPIST MR D
“Environment set up prior to transfer to community hospital”
COMMUNITY THERAPIST MR D
“Ensure others aware of patient transfer technique”
COMMUNITY THERAPIST MR D
Physiotherapy and
Occupational Therapy in TeleRehabilitation -
POTTeR
Positive feedback
Motivational
Goal planning
Improved communication
Early evidence of time efficient practice
Timing of transfer to community hospital
Wifi access
Using iPads to link staff and patients to prepare for discharge is both acceptable and efficient.
Minimal disruption to patients in hospital.
Potential to minimise length of stay.
Clearer exchange of specialist knowledge to community based staff.
corroborate early efficiency savings indicated from initial results
enhance the rehabilitation process, patient experience and outcome
provide specialist education and support to staff in community settings
EuroQol Research Foundation [internet]. 2015 [cited 2015 March 23]. Available from: http://www.euroqol.org/home.html.
Scott H, Patel R, Hebenton J. A survey of the lower limb amputee population in Scotland 2012. Full report. Glasgow: SPARG Scottish Physiotherapy Amputee Research Group; 2015.