Person-centred care in an acute stroke in-patient setting: don’t give up hope!

When working in an acute busy environment attempting to make even small changes to practice can seem challenging. Frequently the barriers seem relentless, unchanging and tiring. Having recently completed the Bridges Self-Management programme, the team jointly decided to focus on small changes that hoped to support communication and information sharing within the acute stroke unit.  By focusing on small changes the team hoped that these small steps would add up to making a big difference.

The first step was to create a poster to display above each bed space. This poster would share a stroke survivors likes, dislikes, chosen name, and list those people who are most important to them. This information would allow hospital staff to get to know the person and not the bed number. Prior to this project each health care professional has been gaining information about each service user with limited avenues to be able to effectively share in a timely manner.

The Speech and Language therapy team were instrumental on leading with the production of the poster and other team members worked with patients to get their feedback, as well as linking with the dementia specialist work. This poster allows a clear, succinct and quick sharing of person-centred information to support all conversations and care.

This part of the project was full of positivity and quick progress.  Staff members were passionate about supporting new methods of sharing important information. All team members were in agreement that this small change had the potential to improve our practice.

Discussions around launching the new poster opened many questions, and the answers led to more questions. Within clinical work there is very limited protected time for projects and often momentum and motivation can therefore drop if progress does not continue in a positive way. It felt like each step closer to launch we would find another hurdle. We tried not to lose hope and kept finding solutions at each step;

• To meet infection control policy, we ensured lamination of the posters.
• To meet confidentiality requirements, we gained ward management and Matron support, and we set up consent procedures.
• To meet documentation standards, we investigated use of ward computers to upload photos of the posters and timely entry into medical records.

The next hurdle is sustaining this new change to practice… but hope remains.

Katie Bond is a Senior Neurological Physiotherapist based at Cambridge University Hospital, UK.

As part of my role I have been fortunate to be seconded to work alongside CPFT and NWAFT with the Bridges team to continue to work on supporting and sustaining self –management across the stroke and neurological rehabilitation pathway for Cambridgeshire and Peterborough patients. This has been funded by Health Education England