Abstract
Effect of Early Intervention By Physiotherapy And Occupational Therapy On Older Inpatient Population
S Kotak1, C Miller 2
1 Senior Physiotherapist, University Hospitals of Leicester NHS Trust
2Consultant Geriatrician, University Hospitals of Leicester NHS Trust
Background: Currently, on inpatient medical wards at University Hospitals of Leicester NHS Trust, the first contact by therapy teams (physiotherapy and occupational therapy) is made when patients become medically optimised for discharge. This is due to a number of reasons such as staffing and resource shortages.
Aim: Analyse the effects of early intervention by therapy on patients on a geriatric medicine inpatient ward at a large, teaching hospital. It is hypothesised that earlier intervention can improve patient and service outcomes.
Method: A data sheet was created to capture baseline information including mobility/care needs prior to admission, date of initial contact by therapy, mobility/care on discharge, length of stay and discharge destination. Data was collected over two phases; initial therapy contact at point of patient being medically optimised for discharge, and then with the planned intervention of proactive therapy input early in a patient’s admission.
Results: The data shows an improvement in all measured patient outcomes in the intervention group. The average time from admission to therapy first contact reduced from 6.4 days to 2 days. The average length of stay reduced from 16.3 days to 7.4 days in the intervention group. 70% of patients left the hospital with a reduction in their mobility status in the control group, whereas only 32% of patients left with worse mobility in the intervention group. 41% of patients in the control group left with new or increased care provision compared to 36% in the intervention group. The data also showed that a higher proportion of patients were mobilised by ward staff and less patient were discharged to 24 hour care settings in the intervention group.
Conclusion: Therapy (with the help of the wider multi-disciplinary team) should proactively identify patients in need of therapy input as soon as safely possible during an inpatient journey. This shows that adopting this approach leads to improvements for both our patients and our service.