Occupation

Abstracts
I am a senior lecturer at Newcastle University specialising in
mechanical design.
P6
Therapies preoperative service for foot and ankle
patients in elective orthopaedics
Waddington L, Nottingham University Hospitals NHS Trust
Background: Within Elective Orthopaedics, we aim to facilitate
safe and timely hospital discharges following a surgical
procedure. Following foot/ankle surgery, the patient may be
non-weight bearing. This is limiting for mobility and daily
activities. Previously Occupational Therapy (OT) would assess and
treat post-operatively, however discharge delays were evident at
weekends. Service Improvement: We have a combined therapies
assessment (OT and Physiotherapy) within the pre-operative
clinic to assess and prepare patients with a realistic plan for their
discharge. The patients’ needs are assessed, and collaborative
recommendations and plans are made. This preparation means
that less input is required post operatively (NHS: Institute for
innovation and improvement, 2006–2013).
Patient Survey Methodology: Following this intervention, the
details of 56 patients were collated. This was to gather the
patient’s experience of the therapy interventions. Patients were
telephoned by either a hospital volunteer or support worker and
37 surveys were completed.
Results & Recommendations: All patients rated the quality of
the therapy pre-op service as Good or very good which led to
them feeling safe on discharge, especially post ankle fusions,
replacements and reconstructions. Other themes were around:
struggling at home, if living alone and struggling to use the
stairs and elbow crutches. The average length of hospital stay
was 3.21 days. 48% of patients reported examples of obstacles
delaying their discharge as awaiting plaster cast and medication.
Conclusions and recommendations: The survey has given our
department information to share and learn. The therapies preop
assessment led to significant patient satisfaction, and this
treatment intervention using a combined therapies approach will
continue. The results will be shared to formulate action plans.
The information can be used for staff training, and the project
can be shared internally and externally.
References
NHS:Institute for innovation and Improvement (2006–2013)
Pre-operative assessment and planning. Available from: http://
www.institute.nhs.uk/quality_and_service_improvements_tool/
pre-operative_assessment_and_planning (accessed 1 September
2015)
Keywords
Adult physical health, Service improvement or transformation,
New or emerging roles, NHS
Contact E-mail Addresses
laura.waddington@nuh.nhs.uk
Author Biographies
I studied Occupational Therapy at Sheffield Hallam University
from 2000–2003. Since this time I have worked at Nottingham
University hospitals NHS Trust. As a basic grade I worked on
stroke, Orthopaedics and Paediatrics. I then specialised in
Orthopaedics and became a senior OT. Following this I was
promoted to work as a clinical specialist in the Nottingham Back
and pain team. I then worked as a Practice Development OT
for two years. My current role, as a team Leader within Elective
Orthopaedics. Within this leadership role, my team assess and
treat patients having a range of elective Orthopaedics surgeries.
Posters
P7
Falls response service: a joint initiative between OT
and the North West Ambulance Service
Bedwell R, Tracey S, East Lancashire Hospitals Trust
Falls and fall related injuries are a common and serious
problem for older people aged 65 and over, often resulting
in pain, distress, reduced mobility, loss of confidence, loss of
independence and isolation. Falls in older adults are a significant
cause of hospital admissions with an estimated cost to the
NHS of more than £2.3 billion a year (NICE 2013). By 2036 it is
predicted that 140,000 hospital admissions in the UK each year
will be due to falls (COT 2015).
Falls Response Service (FRS) was an initiative to address winter
pressures 2014–15 and to evaluate the benefits of the service.
North West Ambulance Service (NWAS) conveyance rates for
people aged 65 and over following a fall were 79%+.
The team comprises of one OT and one paramedic responding to
999 emergency calls. Our primary focus is people aged 65 and
over who have fallen in their own home, whether independent
living or care home, with no apparent injury. Another role of
the FRS is to triage referrals from NWAS communication system
(ERISS) from other ambulance crews who have attended people
who have fallen.
Aims
• To reduce hospital admission due to social or non-medical
factors
• To reduce the number of older people presenting at the
emergency department following a fall
• To reduce demand for Paramedic Emergency Services
• To deliver immediate and long term actions to support older
people to remain safely at home following a fall
Outcome
• In 5 months FRS has attended 360 incidents and kept 75%+
at home
• We have managed 600+ ERISS falls referrals, offering
preventative intervention
• NWAS figures show an increase in falls incidents, but
conveyance to hospital has been reduced
The scheme has demonstrated positive outcomes in all areas,
with financial savings for NWAS and ELHT, plus reduced bed
days.
The poster will demonstrate the components of the FRS and its
impact on the trust and local population.
References
College of Occupational Therapists (2015) Occupational Therapy
in the prevention and management of falls in Adults. London:
COT
National Institute for Health and Care Excellence (2013) Falls:
the assessment and prevention of falls in older people. Clinical
Guideline CG161. London: NICE
Keywords
Adult physical health, Practice development, Innovative practice,
NHS
Contact E-mail Addresses
rachel.bedwell@elht.nhs.uk
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