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Effect of a seven-day acute inpatient neurophysiotherapy service on physiotherapy provision, length of stay and patient experience

Research output: Contribution to journalArticle

Mark Patrick McGlinchey, Charlotte Buttery

Original languageEnglish
JournalJournal of evaluation in clinical practice
Early online date17 Jul 2019
DOIs
Publication statusE-pub ahead of print - 17 Jul 2019

King's Authors

Abstract

Rationale, aims, and objectives
National policy, guided by research, suggests several patient and service benefits achieved by providing 7‐day health care. Therefore, a 7‐day inpatient neurophysiotherapy service was introduced at a large teaching hospital in London. The study's aim was to evaluate the effect of the 7‐day service on physiotherapy provision, length of stay (LOS), and patient experience.

Method
Baseline data from the 5‐day service were collected for 6 months. Data included time to first neurophysiotherapy assessment, average number of sessions per week, total number of physiotherapy minutes provided, physiotherapy LOS, and hospital LOS. Once 7‐day working (7DW) commenced, involving daily physiotherapy for all patients applicable for physiotherapy, data were collected for 6 months and compared with the 5‐day service. Patient and carer feedback were also obtained through structured interviews from a sample of patients and their carers.

Results
Data from 286 patients (148 patients pre and 138 patients post 7DW) were analysed. Post 7DW, the percentage of patients seen by a physiotherapist within 24 hours increased from 69.9% to 94.9%. Patients also received more physiotherapy sessions per week during their hospital LOS. For demographically similar patients, physiotherapy LOS (24.8‐17.4 d, P = .02) and total hospital LOS (32‐23.4 d, P = .04) significantly reduced. Twenty‐four structured interviews were completed (17 patients and seven carers). Carers preferred a 7‐day physiotherapy service as it was perceived to provide more physiotherapy for patients. However, patients valued the consistency of seeing the same therapist during the 5‐day service, as this was perceived to develop therapeutic relationships and result in faster treatment progression.

Conclusions
This study has demonstrated that 7DW can improve timely access to more intensive physiotherapy whilst reducing LOS for demographically similar patients. Whilst patients and carers liked having daily physiotherapy, consideration is required to ensure consistency of therapists treating patients.

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