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Interested in finding out more about Bridges?

 

PRACTITIONERS click here for detailed FAQ's or click here for the evidence supporting the programme

 

COMMISSIONERS and TRAINING MANAGERS please click here

 

PATIENTS/CARERS click here

 

RESEARCHERS/COLLABORATORS/GENERAL ENQUIRIES please register your interest here...

 

 

Bridges Open Workshops

 

We run open workshops for individual practitioners working in neurological and general rehabilitation, or perhaps you work with stroke survivors in the voluntary or third sector.   

 

Click here for more information about our open workshops

 

 

 

 

Croydon Priorities Project

Background

The Croydon Priorities project was funded by the NHS South London Cardiac and Stroke Network following a successful bid for a priority project as part of the National Stroke Improvement plans. It aimed to explore the feasibility of using the Bridges Stroke Self-Management Programme (known at that time as ‘Stepping Out’) with patients throughout the stroke pathway in Croydon.

The initial scoping study carried out at inception of the project gave the following results:
• Staff training, skills and competencies in stroke care were identified as an important issue by members of the stroke teams
• There was minimal evidence of joint working, and training across different teams throughout the pathway
• There was a lack of continuity in approaches to goal setting and treatment plans
• Not all goals and treatment plans were agreed with patients and their carers
• Staff were not consistently using individualised treatment plans
• Self-management principles were not embedded into regular clinical practice

Project Objectives

By introducing the Stepping Out Programme to stroke teams working in the acute, intermediate care and community settings in Croydon, the aims were to:
 
• Foster a  more consistent approach to patient-centred rehabilitation across health and social care settings
• Promote self management principles and patient-led goal setting throughout the stroke pathway
• Improve transfer of care and communication of patient goals
• Evaluate the influence of  the programme on staff beliefs and attitudes  about self-management
• Monitor patient outcomes (QOL , self-efficacy and mood) in those patients using the Stepping Out programme
• Determine whether the programme can be recommended across the sector and incorporated into core competencies if successful

Methods

1) 24 staff from multi-disciplinary groups attended introductory workshop

2) Participants were encouraged to use the workbook with as many suitable patients as possible

3) 19 staff attended follow up workshop 6 months later

4) 19 staff questionnaires completed, 10 in-depth case reflections

5) 12 complete data sets returned on patient outcomes

Key outcomes

Survey of beliefs and attitudes:
72% of participants stated that their practice had changed as a result of the programme. The areas they felt had changed were their approach to goal setting, with a change towards a more patient-centred approach, letting patients have hope with their goals and awareness of promoting self-efficacy.
 
Case reflections:
Thematic analysis of practitioners’ case reflections presented the following:
• Transfer of care requires good communication of goals and treatment plans between teams and services
• Whole teams need to be trained to use the programme – otherwise consistency of approach through the pathway will be difficult
• Commitment and belief in the concept is required from clinicians
• Use of the stroke workbook and fostering self management, especially when families are engaged, can improve the whole transfer of care
• The programme enabled the whole team to use a more a client centred approach which empowers patients to set their own goals
• It can be difficult to use programme in acute setting, but goal setting and self-management principles can still be introduced

Lessons learnt and future plans
 
• Pre planning and engagement of senior management is vital to ensure project is given priority
• Feedback of the project at a clinical reference group helped to raise the profile and facilitate engagement from key stakeholders
• Earlier identification of champions within the teams would have been helpful to support and encourage other colleagues
• Relevant outcome measures and commitment to use the programme should be agreed by all stakeholders
• Teams need to develop a clear action plan for sustainability for the programme at the follow-up workshop
• Handover of stroke workbook and goals should be integrated into transfer reports
• Review of stroke workbook and goals can be incorporated into 6 month and annual review

 

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