<ul><li>WE ARE  </li></ul><ul><li>Jackie Potts – Physiotherapist </li></ul><ul><li>John Hayward – Social Worker </li></ul>...
NEWPORT INTERMEDIATE  CARE SERVICE L.T.C.N P.A.T.H RAPID RESPONSE NURSING P.I.L.S REABLEMENT TEAM COMMUNITY PHYSIOTHERAPY ...
Newport Reablement Team PHYSIOTHERAPY>>> <<<OCCUPATIONAL THERAPY SOCIAL WORK>>> <<< NURSING Reablement Assistants / PILS c...
Types of client <ul><li>Assessed by Reablement: </li></ul><ul><li>Orthopaedic </li></ul><ul><li>Musculoskeletal </li></ul>...
Social Worker <ul><li>Reablement assessments </li></ul><ul><li>Care planning </li></ul><ul><li>Care monitoring / reviewing...
Staff Nurse <ul><li>Assessment of medical issues </li></ul><ul><li>Continence </li></ul><ul><li>Monitor Obs </li></ul><ul>...
Occupational Therapy <ul><li>Equipment & to make environment safe </li></ul><ul><li>Active therapy </li></ul><ul><li>Trans...
Physiotherapy <ul><li>Assx mobility, gait, balance, exercise tolerance, physical abilities. </li></ul><ul><li>Berg Assx to...
Reablement assistants x 5 <ul><li>80% PT – 20% OT </li></ul><ul><li>Follow set program with PT/OT assx, goal plan, berg sc...
Referral IN Assessment Tools CRT  programme Situation  Inputs  Outputs  Outcomes Discharge review FALLS FORM DATA REVIEW
Initial visit / screen inputs / outputs <ul><li>Unified Assessment  - Domains </li></ul><ul><li>Refer on to other services...
Assessment see data base <ul><li>Medical problems (falls history) </li></ul><ul><li>Gait & Balance </li></ul><ul><li>Footw...
Bundles 1 - 4 <ul><li>Falls driver diagram </li></ul><ul><li>Trigger bundle – set a trigger. devise a screening tool, log ...
PDSA  x 1 <ul><li>Falls trigger / criteria  (3 month) </li></ul><ul><li>Assessment form  (designed) </li></ul><ul><li>1 pa...
PDSA 2 <ul><li>Changes to assessment tool. (3 month trial) </li></ul><ul><li>Problem : different interpretation of what th...
Falls collaborative Workshop 2 Introduced to RISK tools Database
PDSA X 3 <ul><li>Trigger: workshop 2 </li></ul><ul><li>Aim for a RISK Assx tool. </li></ul><ul><li>Pre post differences </...
<ul><li>S.M.A.R.T </li></ul><ul><li>Specific </li></ul><ul><li>Measurable </li></ul><ul><li>Achievable </li></ul><ul><li>R...
 
 
 
Fear
First analysis of the use and scoring on the revised tool Sample size 10 completed forms *  Early figures are most encoura...
What next… Bundle 4 : Monitoring ? Update or Close the plan & Update Falls Log Date Evaluate the Efficacy of the Plan Date...
I  think our work here is done.
QUESTION TIME
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Its all a question of balance 3

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Its all a question of balance 3

  1. 1. <ul><li>WE ARE </li></ul><ul><li>Jackie Potts – Physiotherapist </li></ul><ul><li>John Hayward – Social Worker </li></ul><ul><li>from the </li></ul><ul><li>Newport Reablement Team </li></ul>
  2. 2. NEWPORT INTERMEDIATE CARE SERVICE L.T.C.N P.A.T.H RAPID RESPONSE NURSING P.I.L.S REABLEMENT TEAM COMMUNITY PHYSIOTHERAPY PSYCHIATRIC LIAISON NURSE EXPERT PATIENT CONSULTANT STROKE ADVISORY SERVICE Promoting Independent Living Skills
  3. 3. Newport Reablement Team PHYSIOTHERAPY>>> <<<OCCUPATIONAL THERAPY SOCIAL WORK>>> <<< NURSING Reablement Assistants / PILS carers
  4. 4. Types of client <ul><li>Assessed by Reablement: </li></ul><ul><li>Orthopaedic </li></ul><ul><li>Musculoskeletal </li></ul><ul><li>Neurological </li></ul><ul><li>Respiratory </li></ul><ul><li>Cardiac </li></ul><ul><li>Fallers </li></ul><ul><li>Medical </li></ul>
  5. 5. Social Worker <ul><li>Reablement assessments </li></ul><ul><li>Care planning </li></ul><ul><li>Care monitoring / reviewing </li></ul><ul><li>Carers assessments </li></ul><ul><li>Benefit work </li></ul><ul><li>Alternative accommodation planning </li></ul><ul><li>Falls data base management etc. </li></ul><ul><li>Supervision of other staff / management support </li></ul><ul><li>Oh yes and preparing Power point presentations ! </li></ul>
  6. 6. Staff Nurse <ul><li>Assessment of medical issues </li></ul><ul><li>Continence </li></ul><ul><li>Monitor Obs </li></ul><ul><li>Address medication </li></ul><ul><li>Liaise with DN,RR,GP </li></ul><ul><li>Other… </li></ul>
  7. 7. Occupational Therapy <ul><li>Equipment & to make environment safe </li></ul><ul><li>Active therapy </li></ul><ul><li>Transfers </li></ul><ul><li>Pacing </li></ul><ul><li>Cognitive assessments </li></ul><ul><li>Promote sequencing of tasks </li></ul><ul><li>Facilitation of movement </li></ul>
  8. 8. Physiotherapy <ul><li>Assx mobility, gait, balance, exercise tolerance, physical abilities. </li></ul><ul><li>Berg Assx tool </li></ul><ul><li>Dynamic balance </li></ul><ul><li>Therapy </li></ul><ul><li>Personal exercises </li></ul><ul><li>Balance programme </li></ul><ul><li>Gait – re-education </li></ul><ul><li>Facilitation of movement </li></ul><ul><li>Chest management (COPD) </li></ul>
  9. 9. Reablement assistants x 5 <ul><li>80% PT – 20% OT </li></ul><ul><li>Follow set program with PT/OT assx, goal plan, berg score, exercise sheet, balance or activity plan. </li></ul><ul><li>Single or double handled clients </li></ul><ul><li>equipment. </li></ul>
  10. 10. Referral IN Assessment Tools CRT programme Situation Inputs Outputs Outcomes Discharge review FALLS FORM DATA REVIEW
  11. 11. Initial visit / screen inputs / outputs <ul><li>Unified Assessment - Domains </li></ul><ul><li>Refer on to other services </li></ul><ul><li>Refer to team members </li></ul><ul><li>Provide a reablement programme </li></ul><ul><li>Triggers a FALLS assessment </li></ul>
  12. 12. Assessment see data base <ul><li>Medical problems (falls history) </li></ul><ul><li>Gait & Balance </li></ul><ul><li>Footwear & feet </li></ul><ul><li>Osteoporosis </li></ul><ul><li>Fear of falling </li></ul><ul><li>Cognitive </li></ul><ul><li>Environment </li></ul><ul><li>Continence </li></ul><ul><li>Environment </li></ul><ul><li>BP </li></ul><ul><li>Medication </li></ul><ul><li>Nutrition </li></ul>
  13. 13. Bundles 1 - 4 <ul><li>Falls driver diagram </li></ul><ul><li>Trigger bundle – set a trigger. devise a screening tool, log info, GP template </li></ul><ul><li>Assessment – use assessment form to gain appropriate information </li></ul><ul><li>Intervention – refer on to services, OT /PT within the team, involve GP or falls service </li></ul><ul><li>Monitoring – not there yet ! </li></ul>
  14. 14. PDSA x 1 <ul><li>Falls trigger / criteria (3 month) </li></ul><ul><li>Assessment form (designed) </li></ul><ul><li>1 page (criteria – UAP) </li></ul><ul><li>MDT (everyone could use) </li></ul><ul><li>Cover all areas ( used 1000 lives template) ‏ </li></ul><ul><li>Client details ( date, assessor etc ) </li></ul>
  15. 15. PDSA 2 <ul><li>Changes to assessment tool. (3 month trial) </li></ul><ul><li>Problem : different interpretation of what the questions were asking by different professionals. </li></ul><ul><li>Problem : unsure where/who to refer on </li></ul><ul><li>Problem : yes / no , is the issue already being addressed. </li></ul><ul><li>Result: the form was altered, but still keeping it to a single page. </li></ul>
  16. 16. Falls collaborative Workshop 2 Introduced to RISK tools Database
  17. 17. PDSA X 3 <ul><li>Trigger: workshop 2 </li></ul><ul><li>Aim for a RISK Assx tool. </li></ul><ul><li>Pre post differences </li></ul><ul><li>Sign post to services </li></ul><ul><li>YES / NO guidance </li></ul><ul><li>Tool taken on by Community Physio & others </li></ul><ul><li>See our story board </li></ul>
  18. 18. <ul><li>S.M.A.R.T </li></ul><ul><li>Specific </li></ul><ul><li>Measurable </li></ul><ul><li>Achievable </li></ul><ul><li>Realistic / Relevant </li></ul><ul><li>Timed / Tangible </li></ul>What can’t be measured – can’t be managed
  19. 22. Fear
  20. 23. First analysis of the use and scoring on the revised tool Sample size 10 completed forms * Early figures are most encouraging – however we need to drill down into the YES scores that didn’t change. Story Board for learning set 3, 16 th March 2011
  21. 24. What next… Bundle 4 : Monitoring ? Update or Close the plan & Update Falls Log Date Evaluate the Efficacy of the Plan Date Review The Compliance With The Plan Date Copy Of The Plan To Go To The GP Date Date Of Agreed Timescales and Review Date Plan Agreement With Patient/Family/Carers Date Initiate Bespoke Plan On Need Date
  22. 25. I think our work here is done.
  23. 26. QUESTION TIME

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