Occupational Therapy and Rapid Assessment
17 March, 2025
Therapy cover for front door services
In a bid to enhance patient care and streamline processes, the Rapid Response Team at University Hospitals Plymouth NHS Trust has introduced early therapy assessments for patients waiting in ambulances before being handed over to the Emergency Department.
This integrated team comprises occupational therapists, physiotherapists, and assistant practitioners, all dedicated to supporting admission avoidance and facilitating early discharges.
Addressing the demands
Given the rising demands on emergency services, including delays in ambulance handovers, the team sought innovative solutions to improve patient flow. By initiating therapy assessments while patients are still in ambulances, they aim to address the risk of deconditioning, particularly in older patients who may face declines in function during long waits.
A collaborative approach
Recognising the urgency of the situation, the team engaged with Southwest Ambulance Service, receiving positive feedback on their proposal. After establishing a clear patient screening and risk assessment process, they launched a pilot programme between May and August 2022, despite staffing challenges linked to the COVID-19 pandemic.
During the pilot, therapists donned high-visibility tabards and assessed patients verbally in ambulances. They gathered crucial information regarding patients' home situations and previous health issues, with valuable input from paramedics who had interacted with patients in their homes. This early assessment included evaluating pain levels and coordinating analgesia to prepare patients for functional assessments.
A positive outcome
The results were promising, achieving an 87.5% discharge success rate for the patients involved, whose average age was 78. Most patients were discharged with either no follow-up needs or appropriate referrals for further support, such as increased care packages or community service connections.
Key takeaways
- Early therapy assessments in ambulances improve patient flow and reduce waiting times in Emergency Departments.
- The Rapid Response Team collaborates closely with paramedics to gather essential patient information before hospital admission.
- The initiative aims to prevent deconditioning, especially in older patients, by initiating assessments as soon as possible.
- An 87.5% discharge success rate was achieved during the pilot programme, demonstrating the effectiveness of early intervention.
- The programme has become a routine practice, integrating multidisciplinary efforts to enhance patient care and recovery.
Integration into routine practice
The initiative has since become part of routine practice, allowing the team to screen patients in ambulances alongside those in the Emergency Department. By adapting their approach to support early therapy input, they aim to mitigate the risks associated with hospital stays, particularly for frail older individuals. The collaborative effort across multidisciplinary teams ensures that patients receive the most effective care possible, even in challenging environments.
Overall, this proactive strategy exemplifies how innovative thinking can improve patient outcomes, ensuring that waiting times are utilised productively to support timely discharges and enhance recovery pathways.
This is a summary of an article first published in OTnews, in July 2023. Read it in full at OTnews. Reference: Belamy M and Widgery C (2023) Therapy cover for front door services, OTnews, 32(7): 44-45