The Situation:

Allied Health Professionals lead system improvements in the NHS

¹Allied Health Professionals (AHPs) are very well placed to positively influence public health in the UK:

 – 170,000 AHPs in the UK deliver over 4 Million client/ patient interactions per week

– AHPs work across NHS, Social Care, Education, Private and Voluntary Sectors

– Discuss healthy lifestyles and wellbeing within their assessments

 – Work across the life-course in a wide range of specialties

– Use evidence based behaviour approaches

– Deploy interventions which develop ongoing relationships and rapport with patients

As a result, the way in which Physiotherapy and other Allied HealthProfessional (AHP) services are delivered are undergoing important and exciting changes which are leading whole system improvements across the NHS.

¹ Source: Presentation by Anna Lowe @annalowephysio #Expo17NHS spotted on @weAHPs

AHP services are being expanded and redesigned. More AHPs are being recruited to address the demand on community services. Some will remain within acute (hospital) care treating patients on the wards. However, increasingly therapists are being deployed away from centralised hospital departments into community clinics. In addition, vanguard projects within the NHS are looking at skill mixing the primary care workforce. In the future more AHPs will work within primary care practices where for instance,18-33% of general practice workload is diagnosis and treatment of conditions and symptoms, which are musculoskeletal in nature e.g. orthopaedic, pain and rheumatology conditions.This approach ensures that the patients see the right professional at the right time. It has many benefits for the patients and the healthcare system including more rapid access to the specialty, effective treatment, a reduction in the need for investigations and lower rates of prescribing of pain killers etc.

Implication and purpose of the chat:

An aspect of the care that AHPs give is the time taken to record the patient story within clinical documentation in line with record keeping guidance. As for all healthcare professionals, clinical documentation takes up a significant proportion of AHP clinical time The volume of clinical documentation has grown over time as a result of:

• Multi-skilled teams taking on many of the roles that used to be undertaken exclusively by doctors; these require specific documentation
• Complicated conditions and therapies requiring the support of multi-disciplinary teams across complex care pathways need to be documented and communicated rather than just describing what they did.
• Long, complicated medical histories and complex needs – all of which need to be documented and communicated to the multidisciplinary teams
• The change in caring culture, whereby patients/parents/carers are now seen as partners in care, involves more communication than used to be required in a paternalistic medical environment

To accommodate the growth in demand for AHP services in hospital and in primary care there is a need to maximise investment in the front-line services and reduce/release administration workload and backlogs.  The use of technology has the potential to support this goal by streamlining back office administration and providing ‘self-service’ solutions for therapists at the point of care.

Questions 

• Are there areas of care that AHPs document rather than others?
• How much time do you spend doing patient record keeping?
• Which bits of the patient record keeping do you tend to do most of e.g.  assessments, treatment plans?
• What elements of patient record keeping are the biggest challenges for you?
• What things (if any) tend to be missing from the patient record and how do you overcome this?
• How does completing patient documentation impact on the time you spend with your patients?
• How does completing patient documentation impact on you going home at the end of your working day?
• If you use an electronic patient record has this helped or hindered your documentation of patient care?
• What tips and tricks do you have for making patient documentation easier?
• Has anyone used speech recognition/speech to text technology to do patient documentation? If so, how did you find it?

About our guest hosts

Nuance Healthcare Solutions (@voice4health) enhance the production and management of clinical documentation by simplifying how nurses interact with technology. Nuance speech recognition solutions turn voice into text three to four times faster than typing, recognise clinical language and enable voice navigation of clinical systems including the patient electronic health records anywhere, anytime on any device. Now nurses can focus on capturing the patient story and get back to caring for their patients.

Benefits of Nuance Healthcare Solutions:

• Reduce the administrative burden of clinical documentation improving nurse productivity by 10-15% per day.  That’s at least another 30 -60 minutes per day freed up or more time with your patients. (Based upon a University of Dusseldorf JMI study, Alder Hey Speech toText report Nursing Times report )
• Reduce paper-flow, backlog of letters, referrals and discharge notes and reduce document turnaround time.
• Puts the patient back at the centre-of-care, improving communication and transparency with patients and their experience and feeling of well-being
• Document the care record of the consultation with the patient in real-time improving accuracy, data gathering, decision making and patient safety