Background There is a large body of evidence demonstrating the benefits of palliative rehabilitation for hospice patients. Physical function and independence are high priorities for patients living with advanced illness enabling them to maintain their autonomy, control and dignity (Tiberini & Richardson, 2015). As well as benefitting patients, a rehabilitative approach also offers health economic benefits for the organisation (Tiberini & Richardson, 2015). This approach is well established within our outpatient setting but the multi-disciplinary approach on the in-patient unit (IPU) was recognised as being less focussed on patients’ goals and priorities. The benchmarking document (Hospice UK, 2015) was subsequently used to help identify areas for short and long term development on the IPU.
Aim To evaluate the introduction of a more integrated rehabilitative approach to patient care on an In-patient unit.
Methods Between April – June 2017, activities included a literature review, service mapping, benchmarking, training of nursing and medical staff on rehabilitative techniques, and the Rehabilitation Team on new processes for initial patient assessments.
From July 2017- June 2018, ‘quick fix’ operational changes were implemented and there was liaison with the leadership team to consider future strategies for rehabilitation. Supporting documentation was developed, staff engagement activities were carried out and data was collected.
Patient feedback was obtained and Goal Attainment Scores (GAS) used to measure achievement of personal goals.
Results Our mid-point review demonstrated positive changes, including adaptions in the delivery of care to focus more on patient-centred rehabilitative goals across the multidisciplinary team. Data collection is continuing and the final evaluation will take place in July 2018.
Conclusion Throughout the implementation of the project, challenges were identified in terms of the difficulty of initiating and maintaining the momentum of a cultural shift which has been previously evidenced. The final evaluation will therefore take account of both the objective outcomes and our reflections on how these challenges were addressed.
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