As COVID-19 spread throughout the world, clinicians and researchers rapidly published guidance and data and shared their experiences in the hope of understanding the virus better. Their shared purpose was to keep more patients safe from becoming acutely unwell or dying. While the initial focus was on treating the hospitalised, one Trust was also thinking ahead to the challenging recovery many would face.
About the Author
In this interview Patient Safety Learning talks to Cath Edwards, Trainee Advanced Specialist Practitioner in Chronic Obstructive Pulmonary Disease (COPD) at Lancashire Teaching Hospitals. Cath and her colleagues created a free multimedia platform to help people manage their recovery from COVID-19 as safely as possible.
Questions & Answers
Hi Cath, can you tell us about yourself and why the platform was developed?
I’m a Physiotherapist, currently training as an Advanced Specialist Practitioner in COPD. This year, like a lot of my colleagues, I was redeployed to support COVID-19 wards.
We knew patients would be discharged when medically optimised and it was safe to do so, but that the discharge pathways from hospital would be different when working in a pandemic. To support meeting patients’ rehabilitation needs as early as possible and to facilitate the transition from hospital to home, we recognised a gap in information and resources for patients with COVID-19. We wanted to fill that gap.
Our Respiratory Consultant started the conversation. He suggested we produce ‘Joe Wicks style’, short and engaging videos, with content created by a multidisciplinary team (MDT) and designed to help patients recover at home. That planted the seed for the platform and my colleague Emma and I took on the project management from there.
Who was on the team?
We quickly brought together a brilliant team of Occupational Therapists, Physiotherapists, Dieticians, Psychologists, Speech and Language Therapists and Specialist Nurses…our content creators. They produced a wealth of resources to help patients manage their mental, physical and nutritional health in recovery and to guide them through exercises to ease symptoms such as breathlessness.
We are also exceptionally lucky to have an amazing Blended Learning Team at our Trust, who produce high quality, multimedia, online content. They designed and built the multimedia platform to meet our brief and were integral to getting the project launched.
Did you work with patients to create the platform?
No, unfortunately we didn’t have time. The priority at the start was to launch a product to help patients who were in immediate need of rehab support. Which we managed to do in just two weeks. We know how important it is to engage patients in our services though and, since the launch, we have been collecting user feedback which will prove immensely valuable when we review our content.
We’ve also had clinicians from other hospitals highlighting areas of need which will help us develop the platform. A colleague from London, for example, noticed that some patients were struggling with the upper limb exercises due to shoulder damage from prone lying (a position commonly used to help those with COVID-19). We can use feedback like this to refine the platform, so it continues to be relevant and useful.
Has the response been positive?
It’s been amazing. The platform was initially launched as a resource for our own patients but has now has been accessed in more than 70 countries had nearly 50,000 users! Patients tell us they are grateful to be able to get the right support so they can develop the confidence to manage their own condition. It has also provided many people with much-needed reassurance. Reassurance that some frightening symptoms, such as breathlessness, are an expected and normal part of the recovery process. Reassurance that the challenges they are experiencing are being clinically recognised. Reassurance that they can do something to help themselves.
Is this resource just for patients who have been in hospital?
It was designed to help patients with their initial recovery after being discharged from hospital. But we’ve found that many people who are experiencing a slow and debilitating recovery from COVID-19, and were never hospitalised, are also finding it incredibly valuable. Feedback from this group of patients has shown a huge sense of relief that there is advice and support available for them and they are not being dismissed. Many GPs have also been signposting patients to our platform as a source of follow up advice and guidance. With access to face-to-face rehabilitation very limited, it’s great that the resource is being shared more widely through primary care and platforms like the Patient Safety Learning hub.
Why do you think it has been so successful?
I think we identified a need and responded to it very quickly. Our Trust has a strong leadership culture and right from the start of the COVID-19 response, they told us if we needed to make something happen, they would remove the barriers. Without that we couldn’t have achieved what we did in two weeks. The format was also fairly unique for that area. Others had produced pdfs and static documents but nothing with quite the same digital functionality. I think that appealed to people.
Would you do anything differently?
I honestly don’t think we could have done anything differently given the immediate need for the resource but if I were to manage a project with less time pressure, I’d make sure we had developed a really clear brief. I think if we’d had more time to refine the brief, we would have saved time later in the editing process
What is the risk if patients who need rehabilitation can’t access the sort of information and support offered on your platform?
The risk of patients not being able to access the right support is that their recovery may not be managed as well as it could be. Symptoms and side effects could last longer and have a real impact on someone’s ability to function and undertake daily tasks. Some patients who have had COVID-19 will develop Post Viral Fatigue Syndrome. Getting the right advice early on could help manage PVS symptoms or even prevent it from developing.
What more will be needed to keep patients safe during their recovery from COVID-19?
There needs to be more funding and resource for rehabilitation services. At the start of the pandemic response, there was a big push to free up bed space and reconfigure Intensive Care Units to accommodate COVID-19 patients. Then there was another big push to rapidly manufacturer more ventilators. Rehabilitation is the next big crucial phase in the care pathway of COVID-19 patients and warrants the same level of action, investment and urgency. If rehab services are not properly funded in early acute settings, community care and for partners like the British Lung Foundation, it will be impossible to help patients achieve their best possible quality of life post COVID-19.
Our experience is that everyone in the Multidisciplinary Team is passionate about the importance of rehabilitation and the huge difference it can make to a person’s future quality of life. COVID-19 has highlighted how under resourced and undervalued it has been for too long now. I hope we see a massive shift now.
Have you or your team developed an innovative resource to help improve patient safety and reduce harm?
Or perhaps you're a patient who has used the platform Cath talks about in the interview and would like to share how it has impacted your recovery?
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COVID-19 recovery resources (for patients and staff)