Transcript Bridges through stroke pathway

Olivia Kemsley
Physiotherapy team leader
Kingston Stroke Unit
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20 bedded stroke unit, set up in November
2009
Cover 5 boroughs including Kingston
Majority of teams we refer to have had
Bridges training
MDT including physio, OT, SLT and nurses
completed Bridges training Feb 2011
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Given out 25 workbooks in past year
Mostly given just before discharge or awaiting
rehabilitation
Have given workbooks to patients with
cognitive and communication problems by
involving family members
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Workbook introduced to patient and family by
keyworker
Time taken at introductory session to go
through work book and discuss patients
goals
Not frequently followed up as therapists
priorities are organising discharge
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Stroke Co-ordinator Chris Jones –
unfortunately temporary post, now finished
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Tolworth Cedars Unit
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Kingston ICT
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Richmond Community Neuro Rehab Team
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Reablement
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Not enough time
◦ Incorporate into treatment session
◦ Base treatment session around workbook
Wrong environment/Too early
◦ Introduce workbook prior to discharge home or to
rehab
◦ Patients with low mood have benefited from
workbook
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52 year old lady
Very low mood
Unable to identify achievements so far
Unable to break down future goal of Walking
into smaller stages.
Introduced Bridges workbook
Therapist and family came up with
achievements so far, then left with patient to
think about future goals
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Goal setting more patient centred
Move away from SMART goals with
terminology
Developed role of keyworker
Improved communication in MDT and along
pathway
More positive approach, giving hope to
patients
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Broaden range of patients we give it to and
try at an earlier stage
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Follow up more within acute setting rather
than just giving prior to discharge
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Continue to implement self management
approach not just through workbook
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Gain patient feedback at Kingston stroke
forum
Thankyou
Any Questions?