Patient tell us they want to be more active during hospital stay. In the acute hospital environment deconditioning is a major risk factor with around 90% of the day spent sitting/lying. As experts in activity and movement, a Physiotherapy and Occupational Therapy Active Wards Special Interest Group (SIG) was formed to provide peer support and act as a platform for sharing resources and ideas for increasing opportunities for physical activity in the in-patient setting and avoid duplication and allow change to be clinician led.
Group members work in clinical areas across Great Glasgow and Clyde (GGC) bringing together expertise from Older Peoples Services, Stroke, Medical, Surgical, Orthopaedics and Oncology. Drawing on the 9 Principles of Practice Development (first described by Manley & McCormack in 2008) a person-centred, participatory approach was adopted valuing time and space to grow and develop together in creative non-hierarchical ways. Finding long-term solutions that are fluid and not imposed by other, accounting for best evidence, personal and professional experience, taking into consideration the complex operational, organisational and political systems of healthcare. The Practice Development Physiotherapist led using a participatory leadership approach. The group transitioned through the following stages: STORMING: A survey on therapist views on reducing sedentary behaviour in an acute clinical setting and existing evidence was reviewed; purpose, roles, method of communication and priorities for the group were defined. NORMING: Group members regularly shared local improvement work, learning from each other, supporting progress and avoiding duplication of effort. FORMING: Various methods were utilised to gain consensus and create outputs resulting in genuine collaboration. ENGAGEMENT: Members worked with various staff groups, patients and carers, health improvement, volunteer services, 3rd sector organisations, patient experience and equality and diversity teams. Outputs were shared widely both informally including via social media and formally through presentation locally, nationally and internationally. DEVELOPMENT OF PRINCIPLES: The Active Wards Principles give detail to the overarching aim of increasing physical and reducing sedentary behaviour in the clinical environment. They would precede more specific recommendations under each of the Principles.
Results: The group successfully provided peer-support, collaborated, integrated and shared experiences of various sizes and ambitions with 3 main outputs: 1. Tested resources and change ideas to improve opportunities for physical activity in the clinical area. Leading to creation of an intranet page with useful information and resources that can be shared with staff across NHS GGC. A survey system feedback user’s experience. 2. Based on the experiences above and consultation with MDT colleagues and patients, the group devised “Active Wards Principles” to be embedded into revised Care Assurance Standards. 3. The members of the group and team leads completed a survey where they express personal, professional and service development by being part of the group.
Conclusion(s): The group is ongoing but demonstrates what can be achieve when staff have the time, space and ownership of change.
Cost and savings
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Impact of this work is seen in the therapist local areas across professions initially is now influencing board wide-change via Care Assurance Standards.
Top three learning points
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With thanks to the Physiotherapy/Occupational Therapy Active Ward Group members Juliet Harvey, Julie McGuckin, Laura Walker, Erin Walker, Shona Ballentyne, Kate Hughes, Natalie Wood, Carly Johnstone, Michelle McDonald, Lynne Miller, Daniel McGaughey, Alun Myers, Julie Reid, Lynda Williamson, Emma Wilson, Fiona Youngman, Colette Francis, Emily Huston, Lauren Ball and Heather Cameron (Physiotherapy Professional Lead) for sponsoring the group. We are also grateful to the support of Occupational Therapy Professional Lead, Louise Watson; AHP Director, Claire Ritchie; Care Assurance Standard Lead, Margaret Connelly; Volunteer Services; Patient Experience Services and Health Improvement. We welcome Justine Greaves as Senior Improvement Advisor.