Throughout our physiotherapy degrees we are taught the importance of life long learning and continued professional development (CPD). Through sharing experience and knowledge we can learn through others and help improve our service and communicate with patients more effectively.
Patient opinions are vital to our practice. They allow us to gain information on how those at the centre of our service view us and in what ways we can adapt and change to accommodate people. There are physios doing fantastic things across the country but none of us are perfect and we should strive to become experts in our field and be able to deliver that knowledge in a way that patients can appreciate our skills. Often in business it is said for every negative comment said about your business it will take three positives to regain the balance.
Some think we should not look at the NHS as a business. But why not? We have the same goals? In a privatised company if patient care wasn’t exceptional people would not return and the business would fail. With this in mind perhaps it is important for physios to read patient opinions (https://www.patientopinion.org.uk) to see whether we are doing the most we can and if small changes could help iron out these discrepancies. Of course there is lots of good feedback which should be commended and published in the public domain to strengthening our reputation as a profession and maintain standards throughout.
Firstly we will touch on comments expressed by patients through patientopinon.org.uk and discuss possible changes in practice that could help prevent these in the future. Secondly we will talk about positive feedback and how we can draw on what makes a patients experience good and how we can continue to implement these into practice.
Positive Comments – Reflection
“The physiotherapist is a brilliant motivator, and encourages you to work very hard, he really checks that you are doing the exercises correctly”
- To be motivation you need to be positive, enthusiastic and have good communications of goals to be achieved.
- Checking exercises is extremely important to ensure that good technique and appropriate muscle activation is occurring.
“Following on with the physio, again she has been great. I am still attending as the recovery is a long slow process but she seems determined to find a way to solve the problem.” Stepping hill Hospital”
- From these comments perhaps we can draw that the patient felt listened to and felt the physio provided solutions to problems.
“Also had physio appointment on same day. Very friendly again and took a lot of time to explain exercises to me.” Gartnavel royal Hospital
- From these comments we can draw the importance of explaining the exercises.
- Again, first impressions are hugely important. How hard is it to smile and be friendly? This comes up in a lot of the comments. We all have down days but a simple change in our practice ( a smile on greeting) may make all the difference. I think most physios are already quite good at this!
Negative Comments Reflection
“ I also feel the 12 week delay for a physio appointment is much too long.”
Chase Farm Hospital
- Waiting lists are always something that we are contending with. Adequate management and securing funding is very important. One objective comment on this would be the locum work. As a fairly junior physio I was employed by an agency to work in a community setting. They were paying me £18/hour and I’m sure the agency fee was probably the same on top. This seemed ridiculous to me when actually they could have hired me on a bank contract for a few pounds less. I would have reduced waiting lists without them having to pay the agency.
- This inefficiency is something that could be addressed to open more positions than pay excessively for locums last minute to ensure targets are met. Just a thought…
“Delay before seeing physio (inpatient)”
- Perhaps we could minimise the impact for a patient by popping in to inform them that we may be slightly later.
“Having had recent knee replacement surgery, I was told that physiotherapy is the key for getting back to normality.
..the half hour sessions once every 2 weeks is simply not worth it. Not at any time has the physiotherapist been hands on or manipulated my joint.”
- From these comments perhaps we need to explain our treatment choices to the patient. Where clinically indicated consider hands on treatment too – clinical massage, PNF: contract relax, soft tissue mobilisations and mobilisation with movement.
- Something else from these comments is that the patient’s expectation was that ‘physio is the key’ but perhaps education on the fact that physio exercises are also key may have been beneficial, ie “completing them at least 4 times a day (pt dependent) is key to your recovering”. This may have changed the patient’s perspective and laid the responsibility back into their hands rather than feeling it was ‘physio contact’ that was necessary. Healthcare professionals words help formulate a patients perspective and we need to be careful with ours to promote the right message, to motivate and to empower patients.
(physio) I felt like they spoke to me as if I was something stuck to their shoe.
- This may have just been a personality/ perception issue. No patient should feel that we are looking down on them.
- Assume the position that the patient is the centre of the process and we should do our best to explain their condition and educate them on the processes through their care.
“I didn’t see anyone from physio on the Friday or Saturday. I found that I didn’t get enough pain relief (inpatient)”
- Perhaps here we could help time pain relief by coordinating with the nursing staff?
- If we are not going to see patient perhaps a quick check in to explain when we will be coming would keep the patient better informed of their care and manage expectation.
There are a lot of people doing great work across the UK. A few shout outs for those who deserve credit…
“Excellent physio in the Coronation Hospital”
“Clean, the staff friendly and efficient and the medical care outstanding. The OT and Physio staff were also excellent. ” Royal Alexandra Hospital, Paisley
“Excellent initial physio assessment at Princess Royal Telford with Liz. Appointment with Mr Fallows physio consultant was excellent, extremely professional in every way.” Princess Royal Hospital
” Physio after each operation was excellent.and I am now able to do many activities I was struggling with.” Milton Keynes Hospital
“Care of nurses and Physio after surgery was excellent “ Rowley Hall
“Physio’s were marvellous” Upton Hospital
“Up until now I have received excellent care and this is still ongoing in the physio department” Mile End Hospital
“Physio team at Helston and I really cant fault them,friendly,attentive and very knowledgable staff, I would recommend them to anyone.”