COVID-19 FEATURE
Benefits
Enable patients to attend who previously may not have been able to travel to a face-to-face group
Ability for patients to try out techniques in their own home in session breaks
Patients feeling more safe to share personal information
Challenges Learning a new way of doing things ( for both staff and patients )
Access to computers and digital platforms
Inability to complete practical sessions under the direct support of a therapist
Benefits and challenges of remote group work
Impact on outpatient services There are four outpatient services provided by occupational therapy at CUH ; hand therapy , rheumatology , pain , and PRIME ( perioperative review informing management of elective surgery ).
As we entered lockdown , the outpatient teams stopped all faceto-face appointments at short notice and immediately converted these to telephone calls . During the peak , a majority of the outpatient teams were also re-deployed to inpatient wards .
The outpatient services had to rapidly develop ways of providing quality services remotely . As a result , telephone and video consultations using Attend Anywhere were set up and are so far proving successful .
This also enabled therapists to be able to work from home , allowing for easier social distancing within the department .
The teams have also developed new ways of providing treatment and education through electronic resources , exercise apps , updating and developing new leaflets and recording videos on treatments and exercises .
Hand therapists now go to treat urgent patients face-to-face in their dressings and consultant clinic appointments . This was something only done occasionally prior to COVID-19 , but was a service that the hand therapy team had been keen to develop .
This has encouraged greater multidisciplinary working and acknowledgement of the role of occupational therapy , as well as having a secondary benefit of less patient footfall through the hospital .
The pain team therapists have been able to restart some groupwork remotely by trialling a videoconference pain management programme .
The trial group was small in number , so group dynamics were less of an issue , but this may well be different in a larger group .
This has demonstrated to us that virtual programmes could be a future addition to our service . If both were available , it would give more choice for patients , meet a range of learning styles and may increase the number of patients that can join a programme .
Due to the success of the trial , we are now looking into starting our back pain and joint protection programmes in this way , until faceto-face programmes can resume .
The PRIME clinic has also restarted via multidisciplinary telephone and video consultations to support our most vulnerable and frail patients though their elective surgery journey .
The majority of the caseload at present is urgent cancer surgeries , but this is expected to change now elective surgery has restarted .
There is still a lot of work to do with regard to restarting face-toface appointments , as well as managing group work most effectively and inducting new staff , but the outpatient services are keen to use this opportunity to further redevelop and improve the services .
Impact on inpatient services From an inpatient perspective , as a response to COVID-19 , the teams were reorganised into three ‘ super teams ’: neuro ( covering the neurosciences , stroke and major trauma teams ); surgical ( orthopaedics , surgery and oncology teams ); and acute / medicine ( covering our acute care hub , DME and medical teams ).
This enabled better staff cover , allowed for easier flexible working and facilitated provision of much more extensive weekend working .
Around the peak , an 8am to 8pm , seven-day service was running . This allowed the role of occupational therapy to be magnified within the hospital and , as a result , the trust has since requested that we continue to provide a weekend service in areas that we had not done prior to the pandemic .
The occupational therapy department also supported the development of a critical care team .
Pre-COVID-19 , the department had been in the process of developing a business case to increase the occupational therapy critical care provision within CUH , which had previously been based on our neuro critical care unit only .
At the peak , we had three occupational therapists and an occupational therapy assistant covering critical care and the surge beds . Again , the input that the occupational therapists provided was recognised within the trust and we are hopeful that permanent staffing will be approved to enable this to continue for the future .
CUH is the major trauma centre ( MTC ) for the East of England , and as such , we have a rapid access to acute rehabilitation ( RAAR ) unit with 10 major trauma beds , seven acute neuro rehab beds , and four level 2b rehabilitation beds .
The trauma ward was one of the first to be requisitioned as a ‘ Red ’ COVID positive ward , due to its physical location within the hospital and the ward layout , which facilitated social distancing and isolation .
The role of the MTC team changed overnight from providing rehabilitation to rapid assessment and discharge planning .
The team has since returned to its usual ward , and among the many challenges , has noticed visitors returning to the ward to be one of these . Although this has been a positive step towards
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