RNOH Patients’ Group Visit: Physiotherapy Department

Date of Visit:19th August 2008, 1.30pm-3pm

Patient Group Members:Angela O’Halloran, Marion Cumbers

Staff Interviewed:Pam Barsby, Superintendent Physiotherapist

  • Background

Spinal injury patients are assessed by a physiotherapist on admission and their post operative care is commenced immediately after surgery. They can have further care as an out patient if required as necessary by self referral, as can patients with amputations. GP s can refer patients for out patient treatment. Other hospitals also refer patients for out patient treatment–The physiotherapy service treats approximately 6000 inpatients and 3500 outpatients a year. Patients with chronic back pain who have completed the Active Back Programme are given a physiotherapists contact name so that they can ask for help if they have a set back. There is a 3-4 week wait for an appointment. Appointments are usually arranged by phone, or directly with the patient as they come to the department from clinic.

In-patient notes are held in the patient’s file on the wards. Outpatient notes are held in the department. The staff has a very good relationship with the consultants, with good feedback, teamwork and cooperation. Acupuncture and hydrotherapy are offered as required.

The department does not have many appointments not attended, but any available time is used for administration. If patients do not attend they can be delisted, but the department is flexible about this. Leaflets for patients with information about many conditions are available from wall racks.

Physiotherapy cooperates with the Aspire National centre for spinal injuries at RNOH to ensure patients can maintain their rehabilitation after hospital treatment finishes. It is a public sports centre with support facilities and is open to both disabled and able-bodied people.

  • Accommodation

Space is tight in the department especially for storage. There is a small lecture room for training purposes. There is a special room for treating children which is cheerfully decorated, airy and of a good size. However this room is also used for interviews. Children accompanying their parents to outpatient appointments stay with the parents during treatment.

There are 8 cubicles for outpatient treatment. Privacy is acceptable, as curtains are drawn around the cubicles but conversations can be overheard. Orthopaedic physiotherapy does not require a high level of privacy, however a chaperone can be provided if required. Rehabilitation and pain management are at the far end of the department. Since the last visit of the PPI, the hydrotherapy pool has been refurbished and is used whenever required. It is warm bright and attractive and water quality and temperature are carefully monitored.

The gym, where stairs and rails are available for practice, is shared with the regional limb fitting section, which is based at RNOH Stanmore but administered by NorthwickPark.

  • Infection Control

There is a low incidence of infection, but all the usual precautions are observed. The paper on the beds is changed between patients and hand gel is available. For ease of cleaning, only sterilisable toys can be provided for children. The Infection Control Pathways document is very useful to the department. They also consult the microbiology department if they have any concerns, and do not carryout treatment until advice has been taken. The chlorination of the hydrotherapy pool kills any infectious agents including MRSA.

  • Measures of Success

Individual goals are set when a patient is assessed and success is measured against their achievement.

There is no set limit to the number of sessions required and this is governed by the patient’s progress.

  • Staffing

The ward manager appears to run a very happy and efficient department. There is a total of 45 fulltime equivalent staff in post with funding for 45.65. The department is run as a series of teams and does not have trouble in recruiting staff especially for the more junior posts where there are many applicants for every vacancy.

The staff appears to be happy with the working conditions and pay structure, and make the department

happy and efficient. The structure is changing with Physiotherapy, Occupational Therapy, Dietetics,

Speech and Language and the Rehabilitation Ward coming together under one head. It is to be hoped that the department remains as happy and efficient as at present.

  • Training

There is continuous in service training. There are weekly hourly meetings of each team to ensure best practice for patients, to share knowledge and further training of the more junior members of staff, and one hour a week for specialisms. If problems arise then the senior member of the team will give one to one advice. One to one case study peer reviews also take place. The outpatient team choose to add three one hour sessions together and then take a three hour training module. All physiotherapists are registered with the Health Professions Council.

  • Patient Interviews

Mr A. was very happy with his treatment and very pleased with his progress. He felt the hydrotherapy was particularly helpful and only wished it was more than once a week as he felt so much better after it.

However he insisted that this was not a complaint but just an illustration of how much it helped him.

Mrs B was attending for her first visit and could not comment but she said the appoint system was efficient.

  • Recommendations

When the renovation of the accommodation is planned due to the new build, great care needs to be taken

to ensure that both working and storage space are not reduced, and if possible are increased.

Congratulations to the hospital for the improvements to the hydrotherapy pool since the Group last

visited. Both staff and patients are very happy with it.

Congratulations are also due to all the staff running a happy and efficient department.

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