Mary Duguid Occupational Therapist Aberdeen Royal Infirmary.

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Mary DuguidOccupational TherapistAberdeen Royal Infirmary

To examine whether iPads can improve the efficiency and communication associated with the discharge of amputees from an acute hospital to their home or community settings.

All new amputees have an environmental home assessment

Information fedback to patient

Actions agreed

Adaptations/equipment or rehousing proceed

Occupational Therapy in TeleRehabilitation - OTTeR

Amputees transferred to care of community therapist

Handover via email or telephone

Transfer techniquesProsthetic components/informationEarly walking aid

Physiotherapy and Occupational Therapy in

TeleRehabilitation - POTTeR

November 2014 – February 2015

iPad with cisco jabber application

“live” link up with patient in hospital and therapist in patients home

“live” multidisciplinary handover with patient to community hospital therapists

Staff and patient experience surveys

Data gathering regarding patient progress on amputee pathway

Live link up for:

• Three environmental home assessments

• Two handoversto community therapists

Occupational Therapy in TeleRehabilitation - OTTeR

Day 9 post amputationVC environmental home assessmentEquipment needs identifiedEquipment ordered

Day 10 Rails delivered

Day 16 Equipment in situ and rails fitted

Day 18Discharged home

Occupational Therapy in TeleRehabilitation - OTTeR

Instant decision making – saved an estimated 3 days which equals £2,319.

Improved patient health score.

Discharged home day 18.

Occupational Therapy in TeleRehabilitation - OTTeR

“It was brilliant it made me feel that my input to the experience was important”

“It made me feel very positive”

“It made me aware of the practicalities required for my release from hospital”

“I was very happy we were able to do things this way”

Occupational Therapy in TeleRehabilitation - OTTeR

Contact with Mr B

Discuss Mr B’s needs

Immediate consent

Hospital OT directly involved

No additional visit

Occupational Therapy in TeleRehabilitation - OTTeR

“Illustrated exactly what therapists talking about” MR C

  “Encouraged me, I want to go home, motivates

me to practice my transfers here in hospital” MR C

“Made me realise what changes required (wouldn’t have thought about some changes required” MR E

Occupational Therapy in TeleRehabilitation - OTTeR

Physiotherapy and Occupational Therapy in

TeleRehabilitation - POTTeR

“Done a lot to prepare me” MR D

“Beneficial to meet therapists” MR A

Physiotherapy and Occupational Therapy in

TeleRehabilitation - POTTeR

“Patient centred as patient able to meet therapist before transfer”

COMMUNITY THERAPIST MR D

“Visually see transfer not just have it described” COMMUNITY THERAPIST MR D

“Aware of current abilities and goals” COMMUNITY THERAPIST MR A

“More prepared for seeing patients” COMMUNITY THERAPIST MR A

Physiotherapy and Occupational Therapy in

TeleRehabilitation - POTTeR

“Made transition of care more effective” COMMUNITY THERAPIST MR D

“Environment set up prior to transfer to community hospital”

COMMUNITY THERAPIST MR D

“Ensure others aware of patient transfer technique”

COMMUNITY THERAPIST MR D

 Physiotherapy and

Occupational Therapy in TeleRehabilitation -

POTTeR

Positive feedback

Motivational

Goal planning

Improved communication

Early evidence of time efficient practice

Timing of transfer to community hospital

Wifi access

Using iPads to link staff and patients to prepare for discharge is both acceptable and efficient.

Minimal disruption to patients in hospital.

Potential to minimise length of stay.

Clearer exchange of specialist knowledge to community based staff.

corroborate early efficiency savings indicated from initial results

enhance the rehabilitation process, patient experience and outcome

provide specialist education and support to staff in community settings

EuroQol Research Foundation [internet]. 2015 [cited 2015 March 23]. Available from: http://www.euroqol.org/home.html.

Scott H, Patel R, Hebenton J. A survey of the lower limb amputee population in Scotland 2012. Full report. Glasgow: SPARG Scottish Physiotherapy Amputee Research Group; 2015.

maryeliza.duguid@nhs.net