Firth Park Library played host to the December Regional Network Session dedicated to supporting the use of Flo, which enables attendees to share their experience and ideas, as well as promoting best practice in their areas.
The day began with Lisa Taylor and Karen Moore sharing developments across the wider Simple Telehealth community, including the latest additions to www.simple.uk.net, such as example pathways, case studies & blogs and emerging outcomes from across the UK. Lisa and Karen also highlighted the development of supported clinical networks across the community to enable the sharing of best practice regardless of geographical location; the first of these being maternity care focused with the inaugural national special interest group call set for February 2018.
Focus: Early pulmonary rehabilitation management of patients with Chronic Obstructive Pulmonary Disease following acute exacerbation in Sheffield
Cath O’Connor, Clinical Specialist Physiotherapist in Sheffield, discussed her service evaluation of the implementation of Flo in early pulmonary rehabilitation management of patients with Chronic Obstructive Pulmonary Disease following acute exacerbation. Cath focused on patients who had experienced acute exacerbations of COPD (AECOPD), and were taking part in Early Pulmonary Rehab (EPR). In Sheffield, 1 in 3 patients admitted to hospital with AECOPD is readmitted, despite often being asked to participate in EPR; patients may not be receiving the support they require to successfully complete EPR, and this may be a factor in the number of readmissions. Cath, with some support from Karen, developed a pathway supporting this cohort of patients, which focused on symptoms before and after exercise to understand how the patient felt. Results from the evaluation showed that:
- Patients found Flo acceptable.
- Patients felt safe, supported, motivated to exercise.
- Patients felt more confident about self-managing their health.
- Some patients developed new skills in sending text messages that they now use in other areas of their lives, reducing their isolation.
Focus: Community Neurology Team – Improving adherence to physiotherapy in Stroke, MS, Parkinson’s Disease and Head Trauma
Following on from Cath, Ed Rimmer, a Physiotherapist within the Community Neurology Team at Nottinghamshire Healthcare Foundation Trust, discussed his plans for a project integrating Flo across several pathways. The team currently manages patients with a wide variety of conditions, including stroke, MS, Parkinson’s Disease and head trauma. Given the range of conditions and the varied demographic of their patients, a diverse multidisciplinary team of healthcare professionals has developed. The team recognise that their patients can experience condition led challenges to adhere to prescribed medication and rehabilitation, noting the adverse effect that this reduced adherence has on the recovery of their patients.
Therefore, Ed is leading the development of pathways aimed to support an improvement in both motivation and adherence to treatment. Ed hopes that Flo will also help patients to improve their confidence and ability to self-manage, reducing reliance on the team. The plan is to recruit a minimum of 20 patients over the course of 6 months, and then evaluate with both staff and patients with results informing the recruitment of more patients going forward.
Focus: Virtual Wards in Sheffield
The session was led by Rebekah Matthews, Integrated Pathway Manager, who gave an overview of Sheffield Teaching Hospitals implementation of Virtual Wards and the “Okay to Stay” plan. The Virtual Wards demonstrated a decrease in admissions over winter months in 2015/16, leading to a pilot project being launched during winter 2016/17 aiming to improve the integration of health and social care, as well as reduce the number of inappropriate admissions. Patients over the age of 65 who scored the highest on the frailty index were targeted, and through the combined use of a person-centred care plan, the “Okay to Stay” plan & Virtual Wards unnecessary admission were again avoided. Patients on Virtual Wards are typically offered Flo to support awareness, both to the patient and clinicians of vital signs. The combination of being able to monitor patients remotely, and Flo’s prompt advice motivates patients to seek appropriate intervention at the right time, and that any admission that occur are necessary and appropriate.
Regional networks provide a unique opportunity for members to share their learning and experience with others both internal and external to their organisation, and members tell us that these events are highly valued. This dedicated time develops relationships and connects peers from different organisations igniting and energising their journey with Flo.
Many topics were discussed on the day, but a snapshot include:
- Helen Garrity and Bev Aram from Nottingham Paracentesis Team shared their experience of Flo supporting patients with ascites; outcomes include reduced waiting times for patients allowing earlier intervention meaning that patients can often be treated as day cases rather than needing an overnight stay.
- Gail Moore, Heart Failure Specialist Nurse from Sherwood Forest NHS Trust explained how Flo has helped the team to identify the need for appropriate visits to patients by being able to understand the clinical relevance of symptoms remotely and offer clinically appropriate triaged support.
- Jayne Stocks, Clinical lead Assistive Technology, who leads Flo’s integration for Sheffield Teaching Hospitals Foundation Trust provided an overview of current and planned pathways, and highlighted a key learning point around ensuring effective communication across teams in relation to new ways of working.
- A highlight of the discussion focussed around the application of Flo in providing a step down service to patients from existing face to face care. It was acknowledged that patients feel reassured by ongoing contact with their clinicians however that this is not always clinically necessary and can have an unintended consequence of reducing the feeling of independence and “wellness” for the patient. A consensus was gained that Flo would be suited to provide that intermediary step down care to support the patient to transition into self-management.
We would like to thank all who attended and made the day so beneficial for all involved; both those who presented their work and these contributed so much to the community discussion sessions. We hope that attendees enjoyed the day as much as we did, and look forward to the next East Midlands Regional Network Meeting.
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