#endPJparalysis in collaboration with #WeMDT and @AnnMarieRiley10

With over 23 million impressions since January 2017 #endPJparalysis is the epitome of a social movement.  What started with a tweet from Brian Dolan to Ann-Marie Riley and Tim Gillatt in November 2016 has resulted in mass movement to change staff and patient behaviour (please click here to read Brian and Ann-Marie’s latest blog). This is neither a whim, nor a ‘nice thing to do’ without purpose. It is a social movement which has an impact on patient outcomes and has the potential to influence a change in the way care is delivered in the future.

The movement encourages the use of clothes, not pyjamas, in hospital where it is appropriate. Wearing pyjamas and being in bed when not clinically necessary can reinforce ‘sick role’ and could lead to unintentional harm. For example, for every 10 days of bed-rest in hospital, the equivalent of 10 years muscle ageing occurs in people over 80-years old, and re-conditioning takes twice as long as this de-conditioning. One week of bed rest equates to 10%loss in strength, and for an older person who is at threshold strength for climbing the stairs at home, getting out of bed or even standing up from the toilet, a 10% loss of strength may make the difference between dependence and independence.

Sounds simple right? Put people in clothes. However, this requires a whole system shift, a re-think of how care is delivered to include supporting human occupation as an essential part of care, rehabilitation and recovery (please click here to read more about the model of human occupation).

When you hear the word occupation, the first thing thatcomes to mind is probably your job, what you get paid to do, what you trained to become, however, occupation can mean much more. Imagine that it is morning,and you are just waking up. What is the first thing that you do? Why do you do that first? Who taught you to do that? What do you do after your morning routine? When do you eat? What activities do you perform? Can you always choose what you want to do? Why, or why not? Does society tell you what to do? Why, or why not?

Supporting people with their occupations, getting up, getting dressed, eating, drinking and moving, leads to greater independence and enhanced mental well being as they take responsibility for their own health and well being and become active, rather than passive, participants in their journey. And, as a consequence, this would enable more timely discharge, reduce length of stay, and therefore build system capacity by improving patient flow.

So, if we want to change the way hospitals, and other care environments, organises occupations, including the way it values certain occupations over others, how can we do this?

1. How are occupations in care settings organisedand which require a re-think?

           Eating, drinking, getting dressed, activities of daily living?

1. How can organisations be supported in this cultural shift?
2. How can care professionals/staff be supported in this cultural shift?
3. How can patients/people/public be supported in this cultural shift?
4. What one action are you going to take as a consequence of this tweet chat?