Adult and Specialist Rehabilitation

Project

Lead: Selina Wilson Specialist Occupational Therapist

What was the problem?

The team support relatives of patients with complex needs by providing updates and guidance from admission to discharge. However, the growing demands from relatives, including their own social and mental health needs, increased stress and anxiety for staff in the keyworker role. This led to staff sickness and retention issues, as there were no specific educational resources or training to help keyworkers handle the role while protecting their own mental health.

Aim

To reduce keyworker staff stress, anxieties, sickness and promote workforce retention through education and wellbeing in the keyworker role by December 2025.

 
What did we do?

• Completed focus groups and surveys to gather data from keyworkers to identify their needs.
• Set up a working sub-group that developed educational resources for the team.
• Created and launched a keyworker Moodle site with education and resources for keyworkers to provide support for relatives and patients.
• Designed a keyworker leaflet explaining the role to relatives.
• Developed an educational video explaining the keyworker role for staff.

What were the benefits for patients and staff? 

• Keyworkers experienced reduced anxiety and stress by using educational resources and having a better understanding of the role's boundaries.
• ]Feedback from patients and relatives indicated that receiving information and being signposted effectively provided an equitable and inclusive service. Survey findings support this, showing how keyworkers felt their role supports the staff, patients, and relatives, rather than just the relatives as initially thought.
• The qualitative data highlighted how the keyworkers feedback is now supportive of the keyworker role.

Selection of qualitative data

Maintains good communication with families and carers.

Good to have one point of contact.

Relatives feel supported and listened to.

Acts as a way to develop as a member of staff and develop a greater understanding of the patient journey.

It can be very rewarding.

It can prevent stressful issues from potentially escalating.

Centralises everything relating to the patient.

Good to have a collective understanding of the keyworker role so all are doing the same and offering the same level of support as a keyworker.

Enables staff to develop knowledge andconfidence in different areas they may not be exposed to if working elsewhere.

Strengthens staff ability to have difficult conversations, etc. 

Measures used

• Feedback obtained from keyworkers via survey.
• Maintenance working group was set up who met quarterly to audit the Moodle site and review/evaluate future surveys and progress. 
• The project had an extensive improvement plan which identified actions and used Red Amber Green (RAG) rating outcome measures. 

Qi tools used

• Plan, Do, Study, Act (PDSA) cycle.
• Driver Diagram.
• Six thinking hats ©.

Project 

MSK Service diagnosis codes.

Lead: Jonathan Price, Musculoskeletal (MSK) Research Lead

What was the problem?

Only 35% of new MSK physiotherapy patients had diagnosis codes recorded in Rio, the electronic patient record system. This gap limits our understanding of the patient population and reduces the effectiveness of training, service development, and research efforts. Improving coding compliance will enhance data quality and support better-informed decision-making.

Aim

Increase diagnosis code recording for new MSK patients to over 70% within 12 months.

What did we do?

• Introduced a dynamic monthly data dashboard.
• Collected monthly feedback of data for completion rates – individualised.
• Updated induction training.
• Enabled peer comparison and clinic-level visibility.
• Facilitated team discussions on the importance of diagnosis coding.

What are the benefits for patients and staff?

Following targeted interventions, diagnosis reporting for new MSK physiotherapy patients increased from 35% to 90%, significantly enhancing our understanding of the patient cohort. This improvement has streamlined clinician training, enabled targeted research, and laid the groundwork for automated data collection and analysis.

We have begun linking the project to outcome measures, allowing us to identify which patient populations and clinical diagnoses are being managed effectively, and where there is room for improvement. This approach supports the development of more personalised, data-driven treatment plans and is expected to lead to better patient outcomes across the MSK service.

Measures used

• Percentage of new patients with a recorded diagnosis code.

Qi tools used

• Run Chart.