Occupational Therapy News OTnews October 2018 | Page 27

INTEGRATION FEATURE
A compliment received from one patient’s daughter stated:
‘Every member of the team that Mum and I have encountered
have helped us through a very difficult time and given of their time
and expertise throughout the period without exception.’
Our outcome data shows that a large number of our patients
are able to remain in their own homes, rather than being admitted
to hospital or to a step up bed, and do not require ongoing
services, or are able to return to their previous level of support
following the crisis response team intervention.
From discharge information available for January 2018, 157
records show 16 patients were admitted to hospital (16 per cent)
and 53 patients had no further needs following crisis response
intervention (34 per cent).
Being part of an integrated team is also of great benefit to staff,
as they have gained experience and confidence from working
outside of their traditional roles and learning from each other and
having a consistent forum for sharing competencies and skills.
They are often able to treat the patient in a wider
context far more holistically then before. Sharon is an
occupational therapist on the team and says: ‘My
knowledge of nursing and medical conditions has
increased a lot, and I am confident that I can
recognise when a patient is not well and
that I have the clinical reasoning skills to
support my decision making.’
This also enables work to be
shared out more evenly among the
professions, for example, it does
not have to be a nurse who takes a
blood pressure or checks a patients
pressure areas, but this would
indicate a nurse review if a problem
was identified by any of the other competent staff.
Sharon also added that she feels she has
enough knowledge to identify when there is
a problem and she has the clinical reasoning
to support the decision. This can reduce the
pressure on individual staff groups and
increases the flexibility and efficiency within
the team.
While I have identified working extended
hours over a seven-day week as a
challenge, staff who have experienced
it now say they would not want to
go back to working traditional hours.
Sam, an occupational therapist, has
found that working condensed hours
gives more consistency with patient care and
says ‘you can’t do this job in an eight hour
day’.
Occupational therapist Sharon has also
found it has saved her money on childcare
costs and enables her to have more quality time
with her child. She says: ‘This is great for health and wellbeing.’
For most people this has improved their work/life balance and
facilitated a much more flexible working pattern where possible
which, on the whole, promotes a happy workforce.
This working pattern is also massively beneficial to the
organisation and the health and social care economy overall.
Having a crisis team available later into the evening, when more
mainstream services have finished for the day, means that patients
who are in a precarious situation, or who are at imminent risk of
deterioration, have another source of support to prevent a hospital
admission.
This can also reduce the pressure on GPs and other specialist
services who have concerns about their patients. This is also
reflected in weekend working, where many other services are
currently only available Monday to Friday.
This does not take away the value and importance of any
other service, but it does make the health and social care system
more accessible and more robust. I think the traditional Monday
to Friday, 9am to 5pm working that therapists are so used to has
gone, and we have to accept that seven-day working is the only
way forward.
When discussing this with Wendy, a social worker, whose
profession is also used to traditional hours, she remarks: ‘Any
change brings challenges, but the benefits outweigh this long term
and we just have to ride the waves of change.’
A personal reflection
The past three and a half years has been quite a rollercoaster ride,
both personally and professionally. I have learnt so much about
myself, about leadership, about the politics of health care, about
other professions and I have used skills I did not know I had.
Sometimes it has felt like two steps forward and one step back,
with some frustrations, some excitement, some fun and laughter
and lots of great memories.
This has been an incredibly rewarding experience and has
fulfilled my passion for keeping patients out of hospital and being
able to provide wholly and truly, patient centred care. The team
has received many compliments and thanks from patients and
their relatives, but the following sums up the essence of the team.
As one patient’s niece said in March 2017: ‘The GP visited
my aunt and suggested we call the crisis team. Peta, the social
worker, Zoe, the nurse, and Angela, the occupational therapist,
arrived at the house and from the minute they arrived to when they
left they were superb.
‘My aunt was really impressed with the way the team dealt with
a difficult situation in a compassionate way in order to protect her
dignity while sorting the situation out.’
I know that we have made a difference to patient’s lives and
that this experience has made me a much better occupational
therapist.
Judith Hardman is now a semi-retired occupational therapist with
Stockport crisis response team. Email: [e-mail]
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