2 Jul 2018 0 comments
Topic: Brain injury

Mini Victories

On 26th April we launched the ‘Bridges to recovery after trauma’ book to healthcare staff at St George’s Major Trauma Centre, London.  Staff were invited to join two-hour sessions in which they could learn more about how the book can be integrated into their daily work with patients and families.  The book has been two years in the making with a wonderful group of eleven people who have experienced multiple injuries after a major trauma, and their family and friends.  The book authors have generously shared their recovery stories, personal photographs and top tips for finding ways through the challenges of life after a major trauma to help others in a similar situation.

As well as providing an obvious help resource for people after major trauma, the recovery stories in the book provide a valuable opportunity for healthcare staff to enhance their care and rehabilitation through a deeper understanding of the patient and family experience.  According to the book authors, important aspects of self-management support early after major trauma include; hope, not feeling so alone, and feeling confident they can manage when they leave hospital.  Whilst the book can support all of these to an extent, they can be further enhanced through ways healthcare staff work with patients and families.

During the launch events one of the more humbling insights for staff was how discharge home is seen as a celebratory event by them but experienced with fear and anxiety by patients and their families.  This insight was shared by Evi, a book author and former patient of St. George’s Major Trauma Centre, who helped us to deliver the launch events.  Moreover, their fears and anxieties are often hidden and reserved for discussions amongst their fellow patients when staff are not around.  The obvious question from staff to Evi was ‘how can we improve?’.   Our conclusions involved simply asking patients and families how they feel about going home (without worrying that we need to have all the answers) and preparing them for the need to problem solve routine daily activities.

A central concept in self-management support is an individual feeling a sense of control and confidence over their situation.  When many decisions are being made for you, it is important to focus on the small things that you can influence.  The book authors talk about the importance of recording their little victories, for example Evi would record when she could first touch her toes and when she first had her hair washed.  These were the little things that gave her confidence a boost but can be at odds to usual ways of goal setting in rehabilitation and care.

Other ideas about the usefulness of the books for staff going about their daily, busy clinical roles included helping them to answer ‘difficult questions’ from patients and family members about recovery trajectories and how to deal with returning to work and important life roles.  Healthcare staff are motivated to provide the best care possible and utilising the books as part of routine interactions can help them to do just that.

Whilst the launch events felt like a mini victory for us at Bridges, and the book authors, we still have a way to go.  We will be evaluating the impact of the ‘Bridges to recovery after trauma’ books throughout May and June 2018 through short questionnaires for patients and families that were coproduced with the book authors.  We will also capture staff and patient stories on video.  Through engaging with both staff, patients and families we will continue to learn about the best ways to provide self-management support early after major trauma.

The book was made possible through funding from St. George’s Hospital Charity and Giving to St. George’s major Trauma Fund.  We would like to thank Leila Razavi (Assistant General Manager) and Paul Marshall-Taylor (Principal Occupational-Therapist) of St. George’s Hospital Major Trauma Centre for their continued support.  We are indebted to the book authors who have gifted to us their experiences, top tips and insights: David and Barbara, Chris, Evi, Frankie and Carol, Grace and Gloria, Mark, Dan. Henry and Bonny-Lea, George and Dana, Millie and Nick, Minal, Ricky and Ellie, Trevor and Vivian.

Lucinda Hollinshead

Director of Innovation and Training