#PhysioTalk Transcript
Healthcare social media transcript of the #PhysioTalk hashtag.
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| Profile | Tweet |
|---|---|
 | physiotalk @physiotalk Good evening and welcome to tonight's tweetchat. Please say hello and where you are tweeting from. A very warm welcome to all of you this evening especially those of you who have been working today and anyone tweeting for the first time. Just add the hashtag #Physiotalk. |
 | Janet Thomas @JanetThomas47 Hi Tweeting from Edinburgh and I'll be making sure you all use the hashtag tonight :) What is it again? Use #physiotalk in ALL your tweets please! |
 | Karen West 💙 @KWestPhysio @physiotalk Hi. Karen, community physio in SE Hampshire #physiotalk |
 | Sheila Doughty @SheilaDoughty Hello from Sussex #physiotalk |
 | ThePhysioBack @physio_back #physiotalk Hi David, a student from Bournemouth |
 | Joe Middleton @_JoeMiddleton RT @physiotalk: Good evening and welcome to tonight's tweetchat. Please say hello and where you are tweeting from. A very warm welcome to a… |
 | Steffi Bailey @SteffiBailey @physiotalk Hi, Steffi Bailey from West Sussex #physiotalk |
 | ElaineEphysio @eephysio1 @physiotalk Hello! Elaine, Community rehab physio, Glasgow 👋 #physiotalk |
| physiotalk @physiotalk @physio_back Welcome - always great to have students taking part #physiotalk |
 | Lynsey MacD-Ferguson @lynseyferguson6 @physiotalk Hi, tweeting from dull Dundee this evening #Physiotalk |
| Joe Middleton @_JoeMiddleton @physiotalk Good evening from Somerset! Dusting off tweetdeck for what I hope will be a great chat! #physiotalk |
| physiotalk @physiotalk @lynseyferguson6 Dundee is NEVER dull! #physiotalk |
 | Katie Vangucci @KVangucci @physiotalk Hi! Katie from north London #physiotalk |
 | Natalie Robertson @Natalie93671332 @physiotalk Hi Natalie from Cardiff working in Mental Health Services for Older People #physiotalk |
 | Susan Cotton @susancotton18 @physiotalk Hi, Susan in Fife #physiotalk |
 | Scott Buxton @ScottBuxton_1 @physiotalk Hello 👋i'm Scott from Bath #physiotalk |
 | Victoria @VictoriaHatha @physiotalk Evening! Tweeting from Wigan! #physiotalk |
| physiotalk @physiotalk @_JoeMiddleton Welcome - great to have you with us after #physio20 (Yes - my avatar was in the audience...) #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @physiotalk True, the weather is though 🌧🌫 #Physiotalk |
 | Christine Armitage @chrisarmitage80 @physiotalk Hi Christine tweeting from Berkshire #physiotalk |
| physiotalk @physiotalk @dementia_physio Hi - you need to use the #physiotalk hashtag! |
| Susanne Syme @SusanneSyme Hi Susanne from Somerset first ever tweet chat for me #Physiotalk |
| physiotalk @physiotalk @SusanneSyme Great to have you joining in - we hope you will enjoy it! #physiotalk |
 | Chris Martey @ChrisMartey @physiotalk Hi #PhysioTalk, Chris Physio in Bristol 👋🏾 |
 | Saffron @SaffThePhysio RT @physiotalk: Good evening and welcome to tonight's tweetchat. Please say hello and where you are tweeting from. A very warm welcome to a… |
 | Katie the Dementia Friendly Physio @dementia_physio @physiotalk 🤦🏼♀️ of course I do. So sorry!! #physiotalk |
| physiotalk @physiotalk @EmilyRushPhysio Hi You need to use the #physiotalk for us all to follow your tweets |
 | JulesG @JuliaGarvin4 @physiotalk Hi, Julia in Loughborough 👋 #physiotalk |
| physiotalk @physiotalk Fantastic to see some new tweeters tonight. Just remember to add the hashtag #Physiotalk to all your tweets otherwise we don't get to see what you've said. #Physiotalk |
 | Claire O' Connell @ClaireOCPhysio @physiotalk #physiotalk |
| physiotalk @physiotalk Is great to have @dementia_physio with us as our guest host and question setter for this evening! #physiotalk |
| physiotalk @physiotalk @dementia_physio Sorry - but hashtag reminder again :) #physiotalk |
 | Sophie McAuliffe @SophieMcPhysio @physiotalk Hello from Edinburgh #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @physiotalk #physiotalk |
 | Emma Hibbs @emmahibbs23 @physiotalk Hi 👋🏻 I’m Emma from Birmingham #physiotalk |
| physiotalk @physiotalk OK on to the first question set by our guest host and question setter this evening @dementia_physio. What does positive risk taking mean to you and your profession. #physiotalk |
| Joe Middleton @_JoeMiddleton RT @physiotalk: OK on to the first question set by our guest host and question setter this evening @dementia_physio. What does positive ris… |
| Janet Thomas @JanetThomas47 @physiotalk @dementia_physio Taking appropriate risks to enhance someone quality of life. #physiotalk |
| ThePhysioBack @physio_back @physiotalk @dementia_physio To me, as a novice, it is taking an educated approach at pushing a person beyond what they think they can do, in a safe and controlled manner #physiotalk |
| Scott Buxton @ScottBuxton_1 @physiotalk @dementia_physio For me it's all about helping the patient weigh up potential benefits and harms whilst empowering them to make their own decision #physiotalk |
| Susan Cotton @susancotton18 @physiotalk @dementia_physio With this, I usually think of promoting mobility, but with a knowledge that there is increased risk of falls. I'm sure there are many other examples where promoting something may be to the detriment of something else though...#physiotalk |
| Sheila Doughty @SheilaDoughty Positive risk taking means working with people to idenftify what really matters and then supporting them to do it despite risks that may be present #physiotalk |
 | Ciara Mageean @ciaramageean @physiotalk Hi from Manchester #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @physiotalk @dementia_physio For me it is weighing up the potential pros and cons of exercising a certain choice over another. It’s not about eliminating all risk but managing the risks to maximise the ability of the person to choose a certain choice and make their own decisions #Physiotalk |
 | AKIG, PT📚🏋 @abubakarakig @physiotalk Hello, tweeting from Nigeria, Katsina state. #physiotalk |
| Janet Thomas @JanetThomas47 @ScottBuxton_1 @physiotalk @dementia_physio Yes - respecting their decision making is key, even if it makes us uncomfortable #physiotalk |
| Joe Middleton @_JoeMiddleton @physiotalk @dementia_physio Working, in partnership, towards the realisation of the patients wishes and desires. Usually involves going against what your instincts might be, or what seems easiest! #physiotalk |
| Steffi Bailey @SteffiBailey @physiotalk @dementia_physio Encouraging independence and working towards what matters to the patient, working through the barriers that hospitals often have in place to ‘minimise harm’ but can actually cause more harm to the patient in the long run #physiotalk |
| physiotalk @physiotalk RT @_JoeMiddleton: @physiotalk @dementia_physio Working, in partnership, towards the realisation of the patients wishes and desires. Usual… |
| physiotalk @physiotalk RT @ScottBuxton_1: @physiotalk @dementia_physio For me it's all about helping the patient weigh up potential benefits and harms whilst empo… |
| physiotalk @physiotalk @abubakarakig Fabulous to have you with us! #physiotalk |
| Joe Middleton @_JoeMiddleton @physiotalk @dementia_physio Fundamentally recognising that there are no truly 'safe' options, and that everyone is different shades of risky grey. #physiotalk |
| Sophie McAuliffe @SophieMcPhysio @physiotalk @dementia_physio Using our risk assessment and clinical reasoning abilities to make decisions which will benefit the person and lead to positive outcomes #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @SteffiBailey @physiotalk You're so right Steffi!! We have to be so careful to ensure that things put in place to protect do not actually cause more harm!! #physiotalk |
| Scott Buxton @ScottBuxton_1 @physiotalk @dementia_physio that persons decision may be the right or wrong choice in my eyes. My job is to mitigate the risks as much as practicable #physiotalk #frailty #riskmanagement |
| physiotalk @physiotalk RT @dementia_physio: @SteffiBailey @physiotalk You're so right Steffi!! We have to be so careful to ensure that things put in place to prot… |
 | Emma H @littlemissems1 @physiotalk @dementia_physio #physiotalk for me it means balancing taking positive steps forward with safety considerations to enable you to inspire, encourage, motivate and build confidence in your patients (and their families)to strive to achieve their goals. |
 | Ian Tyrrell @IanTyrrell5 @physiotalk Apologies! Late entry! Ian living and working in stoke! #physiotalk |
| AKIG, PT📚🏋 @abubakarakig @physiotalk Thank you for having me #physiotalk |
| physiotalk @physiotalk RT @abubakarakig: @physiotalk Hello, tweeting from Nigeria, Katsina state. #physiotalk |
 | Nikki Walker @nikkiwphysio @physiotalk 👋 I’m Nikki, AMU physio from Norfolk #physiotalk |
| Sheila Doughty @SheilaDoughty Unwise decisions can be made and we should allow patients to make them and take their own risks. Living the life they choose is their right. #physiotalk |
| Natalie Robertson @Natalie93671332 @physiotalk @dementia_physio Using all of the information from the person and/or their carers to provide informed high quality interventions and care plans to enhance someone’s independence and quality of life for someone living with dementia......looking at the whole picture #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @JanetThomas47 @ScottBuxton_1 @physiotalk @dementia_physio I think as physios we are often good (comfortable) at positive risk taking in a controlled environment. I think the uncomfortable feeling but respecting choice is most obvious in discharge planning that’s when the complicated positive risk taking really starts #Physiotalk |
| Ian Tyrrell @IanTyrrell5 @physiotalk @dementia_physio It means Making a clinical judgement that enables people to make decisions that matter to them, despite the worries of the therapist! #physiotalk |
| Scott Buxton @ScottBuxton_1 great point. It's often a hard concept to explain in a hospital setting when home is percieved to be riskier than staying in hospital #physiotalk |
 | Jennifer Kirby @FrontDoorPhysio @physiotalk @dementia_physio With such a fast turnaround there is always a risk that people may ‘perform’ for ED Ax, get home then struggle. But there are risks associated with hospital admission too. Positive risk taking is ensuring patients/carers know what to do if things don’t go to plan #physiotalk |
 | Lucinda Edge @lucinda_edge @physiotalk Hi I’m Lucinda from Dublin - physio with older persons team in ED #physiotalk |
| Sheila Doughty @SheilaDoughty I agree wholeheartedly with this. |
| Claire O' Connell @ClaireOCPhysio @physiotalk @dementia_physio Assessing the patient and situation, taking a risk to enable them as much as possible. Usually involves challenging your own thinking #physiotalk |
| Janet Thomas @JanetThomas47 @_JoeMiddleton @physiotalk @dementia_physio Choose your shade - but do we err to much towards a cautious light grey? #physiotalk https://t.co/54PMGxKeA7 |
 | Laura Kelly @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio An example of this that I see too frequently is keeping a patient in bed to keep them ‘safe’ rather than encouraging them to sit out/mobilise #physiotalk |
 | KB @KBNeuroinfo RT @FrontDoorPhysio: @physiotalk @dementia_physio With such a fast turnaround there is always a risk that people may ‘perform’ for ED Ax, g… |
| physiotalk @physiotalk #physiotalk |
| JulesG @JuliaGarvin4 @physiotalk @dementia_physio For me it’s the risks of getting patients to do things more independently and return to their normal. Some of them are going to do it anyway. Some of them are anxious about trying but you give them the confidence to go for it. At the end of the day, it’s enabling 🙂 #physiotalk |
 | Dr Michelle Bull 💙 @MichelleBull4 @physiotalk @_JoeMiddleton #physiotalk so was mine 😀 I'm transformation programme manager for integrated care and frailty in Guildford and Waverley - and a physio too Bit late - sorry |
| Claire O' Connell @ClaireOCPhysio @lynseyferguson6 @JanetThomas47 @ScottBuxton_1 @physiotalk @dementia_physio Yes I do think we are more likely to take these positive risks than other members of the mdt #physiotalk |
| Scott Buxton @ScottBuxton_1 @lynseyferguson6 @JanetThomas47 @physiotalk @dementia_physio it's the heart of clinical reasoning in geriatrics / frailty. Pragmatic risk taking is absolutely a skill. Mitigating risk as far as possible without intruding on a patients wishes is very challenging #physiotalk |
| physiotalk @physiotalk #physiotalk |
| Sheila Doughty @SheilaDoughty Being in a hospital bed is often quite high risk - we need to remember that. #physiotalk |
| Joe Middleton @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Well, that is the question! What differentiates individual physios and what shade they are 'happy' with? Past experiences are a high factor, imo. #physiotalk |
| ElaineEphysio @eephysio1 @physiotalk @dementia_physio Working with someone to maximise potential/ achieve their goals while acknowledging that seeking to do so is not without risk to them but that the risk of doing nothing is much greater. #physiotalk |
| Joe Middleton @_JoeMiddleton RT @JanetThomas47: @_JoeMiddleton @physiotalk @dementia_physio Choose your shade - but do we err to much towards a cautious light grey? #ph… |
| physiotalk @physiotalk RT @ScottBuxton_1: @lynseyferguson6 @JanetThomas47 @physiotalk @dementia_physio it's the heart of clinical reasoning in geriatrics / frailt… |
| Lynsey MacD-Ferguson @lynseyferguson6 @FrontDoorPhysio @physiotalk @dementia_physio Agreed. I always like to have a plan B communicated for those ED discharges. Who do they contact if once the adrenaline of an ED attendance wears off and things don’t go to plan #Physiotalk |
| Janet Thomas @JanetThomas47 @_JoeMiddleton @physiotalk @dementia_physio I'm sure I'm much happier with risk the older (sorry - more experienced) I get! #physiotalk |
| physiotalk @physiotalk #physiotalk |
| Steffi Bailey @SteffiBailey @lauraakelly80 @physiotalk @dementia_physio Supporting staff who do not feel able to take positive risks is so important and a really difficult skill to teach #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Is there anything worse than that classic line. Home when physio happy .... I wonder what patch of grey that is 😂 #Physiotalk |
| physiotalk @physiotalk #physiotalk |
| Susan Cotton @susancotton18 @JanetThomas47 @_JoeMiddleton @physiotalk @dementia_physio short generalised answer...yes #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 @dementia_physio @FrontDoorPhysio @physiotalk Exactly this #physiotalk |
| David Thompson @DavidT_Physio @physiotalk @dementia_physio Understanding that there are risks worth taking when working in frailty. We can wrap anybody up in cotton wool but often that isn't the approach required to ensure a decent quality of life. Educating family & carers is key to ensuring patients wishes are respected #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @dementia_physio @ScottBuxton_1 @JanetThomas47 @physiotalk And a supportive MDT willing to try and know how to react if it doesn’t go to plan #Physiotalk |
| Ian Tyrrell @IanTyrrell5 @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Past experiences are key! Links to system one and two thinking ! The more we see things the easier it becomes! Hence why the more patient miles you have the easier a decision becomes! And why patience is needed with less experienced members of staff! #physiotalk |
| Nikki Walker @nikkiwphysio @physiotalk @dementia_physio Supporting our patients to make the right decision for them ...helping them weigh up their options... an unwise decision doesn’t make it a poor decision if it’s their decision #personcentredcare #physiotalk |
| physiotalk @physiotalk @dementia_physio @ScottBuxton_1 @lynseyferguson6 @JanetThomas47 Don't forget the hashtag :) #Physiotalk |
| Joe Middleton @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio I reckon my own level of comfort with risk is actually relatively fluid, and can fluctuate day-to-day based on a large number of factors. This is where working in a team is vital. If I am having a risk-adverse day, a colleague can constructively challenge me. #physiotalk |
| physiotalk @physiotalk @SheilaDoughty @_JoeMiddleton @JanetThomas47 @dementia_physio Don't forget the hashtag #Physiotalk |
| Joe Middleton @_JoeMiddleton @lynseyferguson6 @JanetThomas47 @physiotalk @dementia_physio "if we are basing this patients discharge criteria on my mood, then they are in real trouble...." #physiotalk |
| Claire O' Connell @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Previous experience is key, and having a supportive MDT. #physiotalk |
 | Mari @mariand84 @physiotalk Good evening from Sweden #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 exactly this as well! #physiotalk |
| Laura Kelly @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Yeh. Knowing yourself and the MDT are essential when making these “riskier” decisions. The rest of the team constructively challenging plan leads to the wee gems #Physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Particularly with a mask on, how would they know if i am happy 😃 😷 #Physiotalk |
| physiotalk @physiotalk RT @nikkiwphysio: @physiotalk @dementia_physio Supporting our patients to make the right decision for them ...helping them weigh up their o… |
| Joe Middleton @_JoeMiddleton Obviously, positive risk taking isn't just about being discharged from an acute hospital setting... #physiotalk |
| ElaineEphysio @eephysio1 @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio And bringing family/ carers on board! Good communication and explanation of reasoning behind approach can make a big difference. Seek to enable! #physiotalk |
 | Lindsay Sanders @lindzOT @physiotalk Hi I’m Lindsay, clinical lead OT across ED/AAU/MAU #physiotalk |
| physiotalk @physiotalk @LauraDianeCook @dementia_physio Don't forget the hashtag #Physiotalk :) |
| physiotalk @physiotalk A reminder to you all to keep up with the hashtagging please! Just put #physiotalk in every single tweet and you will be fine! |
| physiotalk @physiotalk #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @eephysio1 @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk This- I totally agree with this. Explaining the reasoning behind an approach is key!! #physiotalk |
| physiotalk @physiotalk @lindzOT Welcome - great to have your perspective #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @eephysio1 @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio I normally find even the most anxious of families when the reasons clearly explained and are given the opportunity to ask questions can see why the decision has been made. Overall it’s the perception of hospital being “safe” that can be the first hurdle #Physiotalk |
| Christine Armitage @chrisarmitage80 @JanetThomas47 @_JoeMiddleton @physiotalk @dementia_physio I’m happier with risk when it’s within a team/organisational culture that supports positive risk taking! Much harder working in a more risk averse setting or team #physiotalk |
| Claire O' Connell @ClaireOCPhysio @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio See this too often. Difficult to empower nursing assistants to take the risk to help support a patient out of bed. Sometimes they are more worried about the patient falling than the risk of restricting/deconditioning #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk A supportive MDT makes all the difference- faced with a decision alone, we will avoid risk. But share the responsibility of that risk and we (the team including the patient) are far more likely to take it and, anecdotally, benefit from it!! #physiotalk |
 | Emily Jane @emoily_jane @dementia_physio @lauraakelly80 @SteffiBailey @physiotalk I have started a placement in intermediate care and sometimes patients requiring supervison can be confusing for them when they are nearing discharge. Many patients i have had ask me ‘will i have this buzzer when i am home for someone to take me to the toilet’ #physiotalk |
| Scott Buxton @ScottBuxton_1 @physiotalk @dementia_physio risk taking and positive risk taking are two different things of course. Positive risk taking starts with identification of potential benefit or harm therefore excellent assessment skills are required #physiotalk |
| physiotalk @physiotalk RT @ClaireOCPhysio: @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio See this too often. Difficult to empower nursing assistants t… |
 | Christopher Tuckett @HealthPhysio @physiotalk @dementia_physio I like a cheesy quote slide! 😉 #physiotalk https://t.co/4aIcnjgWqL |
| physiotalk @physiotalk RT @dementia_physio: @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk A supportive MDT makes all the difference- faced with a deci… |
| Katie the Dementia Friendly Physio @dementia_physio @emoily_jane @lauraakelly80 @SteffiBailey @physiotalk I totally agree- I think patients becoming institutionalised is one of the biggest risks we have to take into account when caring for people!! #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @ClaireOCPhysio @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio I wonder how much that is the fear of datix. It would be interesting if hospital acquired deconditioning was datix’d (made up word) in the same way as inpatient falls #physiotalk |
 | Ellena💙 @ellena_farrow @physiotalk @dementia_physio It means not writing “nursed in bed due to high risk of falls” but proper communication between MDT members to ensure patients are up and out of bed using the safest method 😩 #PhysioTalk |
| physiotalk @physiotalk RT @emoily_jane: @dementia_physio @lauraakelly80 @SteffiBailey @physiotalk I have started a placement in intermediate care and sometimes pa… |
| Christine Armitage @chrisarmitage80 @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Either positive or negative previous experiences with complaint management may also play a factor here, and own lived experiences with friends and relatives #physiotalk |
 | Lj @supermummas #physiotalk hi I'm lisa a student and have been wondering if there are any multidisciplinary early intervention in falls nhs services in the uk. I worked for the Ei in pychosis and it really worked in terms of intensive support after first episode to prevent further admissions |
| physiotalk @physiotalk @chrisarmitage80 @JanetThomas47 @_JoeMiddleton @dementia_physio Wondering how we promote this positive risk taking organisational culture? #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @lynseyferguson6 @ClaireOCPhysio @lauraakelly80 @SteffiBailey @physiotalk I think you're spot on here- risk of litigation is huge!! #physiotalk |
| Ian Tyrrell @IanTyrrell5 @ScottBuxton_1 @physiotalk @dementia_physio Also requires a high level of communication skills. Giving people choices, honesty and pragmatism aswell! Being able to give people both sides of the story and knowing the pros and cons of each decision! #physiotalk |
| physiotalk @physiotalk RT @lynseyferguson6: @ClaireOCPhysio @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio I wonder how much that is the fear of datix.… |
 | simon shaw failed by NHS 13 years @simonshaw83 @physiotalk Hi #physiotalk I’m a 13yrs #NHS fail! #systemrot |
| Lj @supermummas I also can spell psychosis 😂 |
| Nikki Walker @nikkiwphysio @physiotalk @dementia_physio When supervising patients at risk of falls we have an impt choice...restrict mobility to reduce the risk of falls(at that moment in time)or embrace the concept of #walkingwithrisk...let’s not feed into fear of falling & unintentionally ⬆️ risk through deconditioning #physiotalk |
| physiotalk @physiotalk RT @ScottBuxton_1: @physiotalk @dementia_physio risk taking and positive risk taking are two different things of course. Positive risk taki… |
| Joe Middleton @_JoeMiddleton @chrisarmitage80 @JanetThomas47 @physiotalk @dementia_physio Without doubt. Important to have peer support to work through these situations. #physiotalk |
| Lindsay Sanders @lindzOT Brilliant #physiotalk this evening on positive risk taking, I think I’ll do a reflective session with our team using these questions 👍🏻 @Dinuli15 @alexhunter_ot @Glacksie @ais_d @rachelnandy |
| physiotalk @physiotalk Don't forget the hashtag to all your tweets and comments #Physiotalk |
| Christine Armitage @chrisarmitage80 @physiotalk @JanetThomas47 @_JoeMiddleton @dementia_physio Team leads need to role model making mistakes and learning from mistakes, all concerns need to be positively listened to, lots of patient engagement for training and development, feedback imperative from any complaints or incidents #physiotalk |
| Christopher Tuckett @HealthPhysio @physiotalk @dementia_physio #Physiotalk https://t.co/ZbwhcTJUCt |
| AKIG, PT📚🏋 @abubakarakig @physiotalk @dementia_physio In terms of building your own clinic for example, you need do it first, after you establish it, thats when u wil come to conclusion, if it fan out fine, that means, diversity of health care delivery and efficiency to the person incontext and the patients involved #physiotalk |
| Steffi Bailey @SteffiBailey @emoily_jane @dementia_physio @lauraakelly80 @physiotalk This is so true, why do we feel the risk is acceptable once their home alone but all the time they have people on call 24/7 if something goes wrong we do not allow them the opportunity to try #physiotalk |
| Claire O' Connell @ClaireOCPhysio @lynseyferguson6 @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio Completely agree. Yes if we datix the number of days patients were not offered to get out of bed, our approach may be different #physiotalk |
| Susan Cotton @susancotton18 @_JoeMiddleton ward setting mobility is classic example - challenge to get consistent approach across MDT, inpatients often report not wanting to upset the staff by asking for help or being independent (wholly or partially) , risk becoming dependant and chair/bed bound by default #physiotalk |
| Natalie Robertson @Natalie93671332 @physiotalk @chrisarmitage80 @JanetThomas47 @_JoeMiddleton @dementia_physio With supportive leaders and teams who are comfortable with clinical challenge but who all support each other if the situation doesn’t go as planned despite all of the risk management #physiotalk |
| Sheila Doughty @SheilaDoughty @scft_ahp @juliafairhall3 @sjinman76 Food for thought? |
| Katie the Dementia Friendly Physio @dementia_physio @ellena_farrow @physiotalk YES!!! And if the patient is to be nursed in bed based on a multifactorial assessment and need...state why!! eg. Spinal precautions. In my experience, there are actually very few good reasons as to why a patient would remain in bed all day!! #physiotalk |
| physiotalk @physiotalk #Physiotalk. Cheesy indeed but very true. |
| Lindsay Sanders @lindzOT Love this! |
| Dr Michelle Bull 💙 @MichelleBull4 Really interesting suggestion - I like the idea of datixing (another made up word) hospital acquired deconditioning #physiotalk Do you think anyone has actually tried this before? @lynseyferguson6 @dementia_physio @physiotalk |
| Karen West 💙 @KWestPhysio @JanetThomas47 @ScottBuxton_1 @physiotalk @dementia_physio And frightens the pants off their families #physiotalk |
| Christopher Tuckett @HealthPhysio @physiotalk @dementia_physio For me it's about sharing the 'risk' with the patient, but in an open and honest way. We mustn't collude with patients into generating false feelings of 100% safety or promising to deliver such certainty. #Physiotalk https://t.co/96DXJytRNw |
 | Laura Cook @LauraDianeCook @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk @dementia_physio Having experience of working in the community can help positive risk taking when in acute #physiotalk |
| Sheila Doughty @SheilaDoughty @lindzOT @Dinuli15 @alexhunter_ot @Glacksie @ais_d @rachelnandy I like this idea - may try too. Need ot get th whole MDT on board. #physiotalk |
| Ian Tyrrell @IanTyrrell5 @lindzOT @physiotalk @dementia_physio Also a key is explaining that risk to relatives! Hospitals/care homes aren’t always the safe haven you imagine! #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 RT @dementia_physio: @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 @physiotalk A supportive MDT makes all the difference- faced with a deci… |
| Lynsey MacD-Ferguson @lynseyferguson6 @dementia_physio @ellena_farrow @physiotalk We sometimes have some confusion between genuine prescribed non weight bearing eg fracture and the use of in medical/ nursing notes stating non weight bearing meaning haven’t got out of bed 🤷♀️. A standardised use of language would be very helpful #Physiotalk |
| Laura Kelly @lauraakelly80 @ClaireOCPhysio @lynseyferguson6 @SteffiBailey @physiotalk @dementia_physio Difficult one as we can prove the benefits of encouraging independence and optimising function but at times the relationship with nursing staff can be fragile will low staffing levels etc. The basics need to be part of daily care and our input as Therapists additional #physiotalk |
| Claire O' Connell @ClaireOCPhysio @emoily_jane @physiotalk @dementia_physio @lauraakelly80 @SteffiBailey We need to empower patients in hospital. It's the safest place to take risks. They should be independent on the ward if they will need to do this at home. #physiotalk |
| Lindsay Sanders @lindzOT Positive risk taking... |
| Janet Thomas @JanetThomas47 @LauraDianeCook @ClaireOCPhysio @_JoeMiddleton @physiotalk @dementia_physio Agree! Often they do things when at home that certainly wouldn't be 'allowed' in a ward setting... #physiotalk |
| Christine Armitage @chrisarmitage80 @MichelleBull4 @lynseyferguson6 @dementia_physio @physiotalk We have had many conversations about exactly this, needs to be as visible as falls and all other harms, reported and learnt from in the same way #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @IanTyrrell5 @lindzOT @physiotalk You're so right Ian!! And nor should they be- if I lived in a care home I would hate for every element of risk to be taken away from me!! #physiotalk |
| Joe Middleton @_JoeMiddleton But, what if the positive risk taken, was for the patient to stay in hospital overnight!? #physiotalk https://t.co/FJoZty4pFO |
| Dr Michelle Bull 💙 @MichelleBull4 @ClaireOCPhysio @physiotalk @lauraakelly80 @SteffiBailey @dementia_physio Do you think there is an awareness of the risks of deconditioning in all staff? Do we need to do more to train and educate in this? #physiotalk |
| Ian Tyrrell @IanTyrrell5 @HealthPhysio @physiotalk @dementia_physio Completely agree! I caveat most consultations with “I can’t guarantee I won’t see you/them tomorrow unless I’m on a day off” #physiotalk |
| Lindsay Sanders @lindzOT RT @SteffiBailey: @emoily_jane @dementia_physio @lauraakelly80 @physiotalk This is so true, why do we feel the risk is acceptable once thei… |
| Dr Michelle Bull 💙 @MichelleBull4 @chrisarmitage80 @lynseyferguson6 @dementia_physio @physiotalk Now this has really given me something to think about...... #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @MichelleBull4 @dementia_physio @physiotalk I am unsure. I have raised the topic at a few MDT meetings. It normally leads to fairly rapid behaviour change. Often comes back to educational gaps in the risks of “bed rest” #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 RT @chrisarmitage80: @MichelleBull4 @lynseyferguson6 @dementia_physio @physiotalk We have had many conversations about exactly this, needs… |
| physiotalk @physiotalk RT @MichelleBull4: @ClaireOCPhysio @physiotalk @lauraakelly80 @SteffiBailey @dementia_physio Do you think there is an awareness of the risk… |
| ElaineEphysio @eephysio1 @JanetThomas47 @ScottBuxton_1 @physiotalk @dementia_physio Supporting their decision and seeking to seeking to minimise the risk as far as possible with their consent e.g. extra supports at home and telecare input #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @lynseyferguson6 @ellena_farrow @physiotalk I think you're onto something here Lynsey!! There can be such discrepancy in what is advised- I once read 'protected weight bearing' and every therapist interpreted it differently!! #physiotalk |
| Scott Buxton @ScottBuxton_1 @_JoeMiddleton @kerrie_hopson #physiotalk *facepalm* |
| physiotalk @physiotalk Would love to know if they have #physiotalk |
| Ian Tyrrell @IanTyrrell5 @dementia_physio @lindzOT @physiotalk Grinds my gears! Older people are allowed to fall, allowed to be curious, allowed to explore! We shouldn’t try and stop this as it will surely lead to iartrogenic harm. #physiotalk |
| Joe Middleton @_JoeMiddleton @IanTyrrell5 @HealthPhysio @physiotalk @dementia_physio "Oh, Joe, Mrs Smith is back in" "Oh? Well, I'll go say hi and chat about how we gave it a go, and our safety net worked. Thanks" <bemused face> #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @MichelleBull4 @physiotalk @ClaireOCPhysio @lauraakelly80 @SteffiBailey I absolutely think that more work needs to be done to highlight the importance of this!! #physiotalk |
| physiotalk @physiotalk RT @IanTyrrell5: @dementia_physio @lindzOT @physiotalk Grinds my gears! Older people are allowed to fall, allowed to be curious, allowed to… |
| Susanne Syme @SusanneSyme #physiotalk |
| Lindsay Sanders @lindzOT @dementia_physio @physiotalk @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 Agree, we see it so much though that it’s the therapists decision. As a leader we have to support our team to realise it’s not just their decision & to engage the MDT to be involved & a part of the decision making #physiotalk |
| Laura Kelly @lauraakelly80 @MichelleBull4 @ClaireOCPhysio @physiotalk @SteffiBailey @dementia_physio #physiotalk |
| Ellena💙 @ellena_farrow @lynseyferguson6 @dementia_physio @physiotalk I’ve never had this confusion on medical wards, although can see it on ortho. I’ve just found people are scared of patients falling and it’s seen as a huge negative, yet they don’t have the same views of lying in bed deconditioning and losing all function?! #physiotalk |
| physiotalk @physiotalk Have you found any barriers to taking positive risks whilst caring for people living with frailty? #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @_JoeMiddleton @IanTyrrell5 @HealthPhysio @physiotalk @KVangucci shared this with me the other day- 'It's not a failed discharge. It's a 'first attempt'.' And I love that!! #physiotalk |
| Claire O' Connell @ClaireOCPhysio @MichelleBull4 @physiotalk @lauraakelly80 @SteffiBailey @dementia_physio I think there is an awareness of it but may not be aware of the long term impact. Sometimes staff may focus on their shift and how patients are at that time but not think of the patient over a period of time #physiotalk |
| Susan Cotton @susancotton18 @physiotalk interesting idea....#physiotalk |
| physiotalk @physiotalk #physiotalk |
| physiotalk @physiotalk @lauraakelly80 @MichelleBull4 @ClaireOCPhysio @SteffiBailey @dementia_physio MAST training? #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 @lauraakelly80 @ClaireOCPhysio @physiotalk @SteffiBailey @dementia_physio Great idea - definitely sounds like there is room for improvement #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @_JoeMiddleton I’d be ok with that. Sometimes despite our best efforts the safest option is hospital admissions. I just like where possible for to explore home first. If we didn’t have any inpatients I’d do myself out of a job that I’m fairly partial to 😂 #physiotalk |
| Joe Middleton @_JoeMiddleton I want to say @AnnMarieRiley10 started this in Nottingham? Or she may know who did? #physiotalk |
| Joe Middleton @_JoeMiddleton RT @dementia_physio: @_JoeMiddleton @IanTyrrell5 @HealthPhysio @physiotalk @KVangucci shared this with me the other day- 'It's not a failed… |
| Lindsay Sanders @lindzOT @IanTyrrell5 @physiotalk @dementia_physio Absolutely! I have told many a patient & their relatives that hospitals aren’t safe places 🙊 I was worried the first time I said it but once I explained why it helped to get them on board with the D/C back home #physiotalk |
| Sheila Doughty @SheilaDoughty and we need to learn from it and try again! |
| Ian Tyrrell @IanTyrrell5 @_JoeMiddleton @HealthPhysio @physiotalk @dementia_physio “Ian, you’re on today, I’m glad to see you” “Why is that” “Because it means I’ll be going home today” I certainly enjoy my interactions with that gent every time I see him! Included him say “nice new uniform, what does that mean you can do?” #physiotalk |
| Steffi Bailey @SteffiBailey @MichelleBull4 @ClaireOCPhysio @physiotalk @lauraakelly80 @dementia_physio We have a 30 minute training session on hospital associated deconditioning and frailty that we run every 6 weeks or so, for all ward staff. It does help inspire the culture on the ward, but I feel like it’s an area you have to keep shouting about to maintain momentum #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @MichelleBull4 @ClaireOCPhysio @physiotalk @lauraakelly80 @SteffiBailey @dementia_physio I think the more education the better. We’ve had some really successful posters, drop in stands, mixed discipline inservice training. I also try to squeeze it in during handovers or MDT meetings. The team are sick of the sound of me #Physiotalk |
| Scott Buxton @ScottBuxton_1 @physiotalk @lauraakelly80 @MichelleBull4 @ClaireOCPhysio @SteffiBailey @dementia_physio yeah what's MAST training? An alternative could be some sim training #physiotalk |
| Laura Kelly @lauraakelly80 @physiotalk @MichelleBull4 @ClaireOCPhysio @SteffiBailey @dementia_physio Sorry. The mandatory and statutory training for new employees and annual refresher training.# #physiotalk |
| Lindsay Sanders @lindzOT RT @IanTyrrell5: @dementia_physio @lindzOT @physiotalk Grinds my gears! Older people are allowed to fall, allowed to be curious, allowed to… |
| Christopher Tuckett @HealthPhysio @MichelleBull4 @lynseyferguson6 @dementia_physio @physiotalk @AnnMarieRiley10 has pioneered this at Nottingham hospital I believe. #Physiotalk |
| physiotalk @physiotalk @lauraakelly80 @MichelleBull4 @ClaireOCPhysio @SteffiBailey @dementia_physio Thank you! #physiotalk |
| physiotalk @physiotalk RT @physiotalk: Have you found any barriers to taking positive risks whilst caring for people living with frailty? #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @ellena_farrow @dementia_physio @physiotalk We are a medical ward 🤦♀️. I could almost see it in ortho #Physiotalk |
| Ian Tyrrell @IanTyrrell5 @lindzOT @physiotalk @dementia_physio I regularly talk about life expectancy and effect on cognitive impairment upon transition to nursing homes. Not as a threat but honesty when making life altering decisions quickly. #physiotalk |
 | Sophie Stoker @sophiestoker_ @SharkerOT @KatieCooper_x ❤️ |
| Laura Kelly @lauraakelly80 @SteffiBailey @MichelleBull4 @ClaireOCPhysio @physiotalk @dementia_physio This is great #physiotalk |
| physiotalk @physiotalk RT @dementia_physio: @_JoeMiddleton @IanTyrrell5 @HealthPhysio @physiotalk @KVangucci shared this with me the other day- 'It's not a failed… |
| physiotalk @physiotalk RT @IanTyrrell5: @_JoeMiddleton @HealthPhysio @physiotalk @dementia_physio “Ian, you’re on today, I’m glad to see you” “Why is that” “Beca… |
| Steffi Bailey @SteffiBailey @lindzOT @dementia_physio @physiotalk @ClaireOCPhysio @_JoeMiddleton @JanetThomas47 As a result of being thought of as a ‘therapy decision’, I think that junior staff are often deterred from progressing patients to independent, for a fear of consequences coming back on them #physiotalk |
| physiotalk @physiotalk Thanks for answering! #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 @lauraakelly80 @SteffiBailey @ClaireOCPhysio @physiotalk @dementia_physio This is great (You beat me to it @lauraakelly80 ) #physiotalk |
| Susan Cotton @susancotton18 @physiotalk A few have been discussed tonight already - other staff and staff groups, low staffing/support levels overall, families and carers having a different perspective of risk to person....challenging when elements of cognitive decline in patient or their nearest/dearest #physiotalk |
| Christine Armitage @chrisarmitage80 @MichelleBull4 @ClaireOCPhysio @physiotalk @lauraakelly80 @SteffiBailey @dementia_physio I’m sure more training could always help, but it also needs to be integral to all under graduate MDT training, and inductions for staff somehow? #physiotalk |
| physiotalk @physiotalk How does a multi-disciplinary team facilitate and support positive risk taking within your speciality? #physiotalk |
| physiotalk @physiotalk #Physiotalk |
| Claire O' Connell @ClaireOCPhysio @physiotalk Reluctance of other staff to take those risks. Patients /families worried about risk taking, even with education. Low staffing numbers will impact on risk taking #physiotalk |
| Ian Tyrrell @IanTyrrell5 @MichelleBull4 @lynseyferguson6 @dementia_physio @physiotalk Once wrote somewhat similar in the medical notes for a patient! It provoked the response I wanted from the ward leadership team! #physiotalk #UsedToBeAHotHead |
| Laura Cook @LauraDianeCook @physiotalk Well meaning family members being over protective, open joint discussions so important #physiotalk |
| Joe Middleton @_JoeMiddleton RT @physiotalk: How does a multi-disciplinary team facilitate and support positive risk taking within your speciality? #physiotalk |
| Scott Buxton @ScottBuxton_1 @physiotalk sometimes permission is all that is needed! Other times it can be fresh eyes at seeing the risks / challenges #physiotalk |
| Lindsay Sanders @lindzOT @IanTyrrell5 @physiotalk @dementia_physio Same! I don’t think people realise. I often think about levels of distress & delirium when our patients have enough insight to know they are not at home #physiotalk |
| Janet Thomas @JanetThomas47 @LauraDianeCook @physiotalk Absolutely! How can we weight up the help they might need from family against letting their mum / dad be as independent as possible #physiotalk |
| physiotalk @physiotalk RT @IanTyrrell5: @MichelleBull4 @lynseyferguson6 @dementia_physio @physiotalk Once wrote somewhat similar in the medical notes for a patien… |
| Ian Tyrrell @IanTyrrell5 @physiotalk Working in Ed it’s about what is the reason you’re admitting a patient and what are the alternatives! Often it is easier to admit than to discharge in the acute environment! Need the appropriate community response to be effective! #physiotalk |
| Joe Middleton @_JoeMiddleton @physiotalk Different perspectives from each individual and each professional group (certain groups may have a greater level of understanding around a certain risk). Dilution of individual responsibility (could be also be a negative???) Constructive challenge and discussion. #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @physiotalk daily MDT where progress discharge plan is discussed. The team are very good (even if I do say so myself) at challenging each other to make the best decisions with our patients goals in mind. Talking through all the options pros/cons and agreeing which is the plan #physiotalk |
| Susan Cotton @susancotton18 @physiotalk I think when your MDT is likeminded it can be reassuring to have an open discussion and share that sense of 'risk taking' - and take on that risk as an MDT, not as a single profession #physiotalk |
 | Philippa Leishman @Leishm1Philippa @AnnMarieRiley10 @_JoeMiddleton #physiotalk we did in Wye Valley then for an unknown reason it got removed. Do you know why it changed @racheldphysio @Jo_burns27 @DawnScull |
 | michelle angus @michangus @MichelleBull4 @lynseyferguson6 @dementia_physio @physiotalk Not datix, but the reason behind prolonged bed rest in spinal fractures appears to be a 'theme' in our spinal morbidity & mortality meetings #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @physiotalk Sharing information & decision making between the MDT, the patient & their important others. Faced with that decision alone, we will avoid risk altogether. But sharing the risk shares responsibility & the patient and the team are far more likely to benefit from it!! #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 @HealthPhysio @physiotalk @AnnMarieRiley10 @AnnMarieRiley10 Would be really interested to know more about this - how you managed it? How you tracked it? what difference it made? #somanyquestions #physiotalk |
| Joe Middleton @_JoeMiddleton @IanTyrrell5 @physiotalk If you don't have the support of responsive community services, who share your attitude to risk, then you are gonna have a really tough time. #physiotalk |
| Claire O' Connell @ClaireOCPhysio @physiotalk In relation to discharge planning, its useful to have consultant / OT/ patient & families all in agreement to take the risk re discharge home. If something doesn't work with the d/c, less likely to have a blame culture /"failed d/c" aimed at specific staff #physiotalk |
 | Sally Howard @salhowardphysio @FrontDoorPhysio @physiotalk @dementia_physio There is sometimes the scenario of...’they will do it for you but they don’t do it at home’. There is a need to listen to carers, what is happening at home and with consent refer the assessment to community colleagues #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @physiotalk We’ve also recently piloted a home first project from the front door which is a rapid response community MDT. This has so far gone well. We meet via teams. Really helped with bridging the acute: community gap and facilitated smoother transitions #physiotalk |
| Claire O' Connell @ClaireOCPhysio RT @dementia_physio: @physiotalk Sharing information & decision making between the MDT, the patient & their important others. Faced with th… |
| Joe Middleton @_JoeMiddleton RT @physiotalk: Have you found any barriers to taking positive risks whilst caring for people living with frailty? #physiotalk |
 | Tom Meredith @Tom_B_Meredith @physiotalk @dementia_physio I've read some brilliant comments and quotes. Heres my personal favourite.... May your choices reflect your hopes, not your fears. – Nelson Mandela I'm not a physio, but work closely with some brilliant ones so I'm going to hash tag away! #physiotalk |
| Christine Armitage @chrisarmitage80 @_JoeMiddleton @IanTyrrell5 @physiotalk Completely agree,so important to be joined up in approach to this, not least to learn together from examples that have gone well and those not so well! #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @salhowardphysio @FrontDoorPhysio @physiotalk This is such a good point!! It then begs the question, if they can do it in the acute setting but choose not to do it at home, why is this? Is there more support needed or is this just personal choice? #physiotalk |
| physiotalk @physiotalk RT @dementia_physio: @physiotalk Sharing information & decision making between the MDT, the patient & their important others. Faced with th… |
| Philippa Leishman @Leishm1Philippa @ScottBuxton_1 @physiotalk @lauraakelly80 @MichelleBull4 @ClaireOCPhysio @SteffiBailey @dementia_physio I agree and hope that we can facilitate this element into a bolt on to manual handling training that would capture new starters and also at updates @racheldphysio #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @physiotalk Most recently the biggest challenge is family not being so freely able to come in an see the patients progress. It is far easier when families can witness the patients abilities #physiotalk |
| Joe Middleton @_JoeMiddleton Barriers to taking positive risks? Exactly this. #physiotalk |
| Ian Tyrrell @IanTyrrell5 @_JoeMiddleton @physiotalk Yup! Or you just try and work with them! It’s a battle but I always find our services to be really helpful despite challenges raised from others! I think it’s all about communication, compassion and being able to have that common goal! #physiotalk |
| physiotalk @physiotalk @Tom_B_Meredith @dementia_physio Please do! #physiotalk |
| physiotalk @physiotalk #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @lynseyferguson6 @physiotalk Could not agree more!! This has had a really noticeable impact on discharge planning for so many reasons!! #physiotalk |
| Christopher Tuckett @HealthPhysio @physiotalk The belief that things can be completely 'safe' is a common misconception I find- from both clinicians, patients and family. #physiotalk https://t.co/UhYQrjcfsP |
| Claire O' Connell @ClaireOCPhysio RT @_JoeMiddleton: @IanTyrrell5 @HealthPhysio @physiotalk @dementia_physio "Oh, Joe, Mrs Smith is back in" "Oh? Well, I'll go say hi and c… |
| Ian Tyrrell @IanTyrrell5 @lindzOT @physiotalk @dementia_physio Saw a change from family home to assisted living the other day which had accelerated cognitive impairment including the toilet being in the wrong place and the bed being the wrong way round! It’s the small details that mean so much. #physiotalk |
| physiotalk @physiotalk Rather than seeing ‘failed discharges’ or falls as an omission of care, how can we increase the understanding of the general public with regards to positive risk taking and its benefits? #physiotalk |
| Emma Hibbs @emmahibbs23 @_JoeMiddleton @IanTyrrell5 @physiotalk Absolutely agree, positive risk taking has to be shared across the services you refer into or use to support a d/c #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @dementia_physio @physiotalk The video demonstration down FaceTime really does not have the same impact #physiotalk |
| Joe Middleton @_JoeMiddleton @chrisarmitage80 @IanTyrrell5 @physiotalk Totally agree. Working in the ED, the only feedback I get is if the patient reattends (usually accompanied with the documentation "unsafe" or "failed" discharge). If we don't see them again, we just assume all went well!? #physiotalk |
| Claire O' Connell @ClaireOCPhysio @dementia_physio @physiotalk @_JoeMiddleton @IanTyrrell5 @HealthPhysio @KVangucci Oh it really frustrates me when I see failed discharge... Especially when they have been at home for a few days and come in with new medical issues! I like first attempt. #physiotalk |
 | Catherine Hopkins @cathhoppo @ClaireOCPhysio @lynseyferguson6 @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio I feel that I remember @AnnMarieRiley10 may have implemented something to this affect in Nottingham for that very reason - to address the consequences of keeping people 'safe' in their beds! Apologies if I'm wrong Ann-Marie #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio Very interested to hear peoples thoughts on this... #physiotalk |
| Christine Armitage @chrisarmitage80 @_JoeMiddleton @IanTyrrell5 @physiotalk I guess that’s marginally better than working on the ward where it’s documented “admit back to xx ward as failed discharge” #physiotalk |
| Christopher Tuckett @HealthPhysio @physiotalk I don't believe 'safe care' is a sensible goal as it's unattainable. I think we should aim for effective care instead....... Then acceptable levels of risk could be defined within this. #physiotalk https://t.co/s0YsAVD6AT |
| Claire O' Connell @ClaireOCPhysio @Leishm1Philippa @ScottBuxton_1 @physiotalk @lauraakelly80 @MichelleBull4 @SteffiBailey @dementia_physio @racheldphysio I think it needs to start at undergraduate level. That seems to work for physios, so why not other members of the Mdt? #physiotalk |
| Joe Middleton @_JoeMiddleton RT @physiotalk: Rather than seeing ‘failed discharges’ or falls as an omission of care, how can we increase the understanding of the genera… |
| Lucinda Edge @lucinda_edge @physiotalk I think it’s really valuable to have the input of other experienced team members - just those insights & perspectives when talking through a case really enhance the holistic assessment & support positive risk-taking #physiotalk |
| Scott Buxton @ScottBuxton_1 @physiotalk Risk i wouldn't say is a barrier to positive risk taking. It is a PART of risk taking in any form. Without it there isn't an appreciation of what's at stake I'd recommend anyone reading this about how to overcome fear of risk taking https://t.co/6LalAPetl8 #physiotalk |
| physiotalk @physiotalk RT @dementia_physio: Very interested to hear peoples thoughts on this... #physiotalk https://t.co/9rDYj3UeBG |
| Laura Cook @LauraDianeCook @physiotalk Challenging each other to always bring the conversation back to what matters to the patient #physiotalk |
| Sheila Doughty @SheilaDoughty Planning to empoly Therapy #ACPs in frailty to work between @nhs_scft Intermediate Care units and Communiy services to support discharges and positive risk taking in people with more complex needs #physiotalk |
| Joe Middleton @_JoeMiddleton RT @ScottBuxton_1: @physiotalk Risk i wouldn't say is a barrier to positive risk taking. It is a PART of risk taking in any form. Without i… |
| Ian Tyrrell @IanTyrrell5 @ClaireOCPhysio @dementia_physio @physiotalk @_JoeMiddleton @HealthPhysio @KVangucci Oh that kind of negative language irritates the s**t out of me! A patient doesn’t fail! I’m sure @_JoeMiddleton will assist with his gif here! But we don’t apply the same language to the young chest pain who came yesterday but came in hit by a bus today! #physiotalk |
| Christopher Tuckett @HealthPhysio RT @ScottBuxton_1: @physiotalk Risk i wouldn't say is a barrier to positive risk taking. It is a PART of risk taking in any form. Without i… |
| physiotalk @physiotalk #physiotalk |
| Joe Middleton @_JoeMiddleton @IanTyrrell5 @ClaireOCPhysio @dementia_physio @physiotalk @HealthPhysio @KVangucci #physiotalk https://t.co/qMWbTgTmyG |
| Katie the Dementia Friendly Physio @dementia_physio @IanTyrrell5 @ClaireOCPhysio @physiotalk @_JoeMiddleton @HealthPhysio @KVangucci Exactly!! How patronising/rude to say that a patient has failed? What are we implying here!! And don't get me started on 'non-compliant' #physiotalk |
| Lindsay Sanders @lindzOT @physiotalk Keep thinking these would make excellent interview Q’s 😂 #physiotalk |
| ThePhysioBack @physio_back RT @ScottBuxton_1: @physiotalk Risk i wouldn't say is a barrier to positive risk taking. It is a PART of risk taking in any form. Without i… |
| Ian Tyrrell @IanTyrrell5 @physiotalk By being honest about the actual harm that is caused by hospital admissions! And more extensive studies like the “what happened to my legs when I broke my arm study” #physiotalk |
| Catherine Hopkins @cathhoppo @physiotalk @dementia_physio I've gone off the idea of 'positive risk' and instead try & explain it as balanced risk-letting the pt choice how they weigh things up by using what matters to them as the key to conversation. Also about being careful of my own biases #physiotalk |
| Claire O' Connell @ClaireOCPhysio @physiotalk Education and advise. Discuss the risks with patients and their relatives.. Highlight pros and cons of positive risk taking. Communicate these risks with the carers or community teams so they are aware of them #physiotalk |
| physiotalk @physiotalk @lindzOT I'm sure @dementia_physio will let you use them :) #physiotalk |
 | katie taylor @Katie_tayls @physiotalk Rephrasing and removing the word ‘failed’, I liked the response in another question that’s it’s a 1st attempt and the safety net worked, rather than failed #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @_JoeMiddleton @IanTyrrell5 @ClaireOCPhysio @physiotalk @HealthPhysio @KVangucci This is brilliant. #physiotalk |
| Ian Tyrrell @IanTyrrell5 @dementia_physio @ClaireOCPhysio @physiotalk @_JoeMiddleton @HealthPhysio @KVangucci Like the this is the 3rd time they’ve declined so I’m discharging them.... I actually had to walk away from people when they’ve said this! 🤦♂️ #physiotalk |
| Christine Armitage @chrisarmitage80 @physiotalk We can’t forget some discharges are a genuine negative experience due to poor communication between teams, lack of setting accurate expectation for follow up care etc. So to me it is a balance, the “first attempt” messaging sounds brilliant though as a starting point #physiotalk |
| physiotalk @physiotalk @cathhoppo @dementia_physio I like balanced risk! #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @physiotalk @lindzOT Oh absolutely!!! I think that is a fantastic idea- share away!! #physiotalk |
| Lindsay Sanders @lindzOT @physiotalk I would love to see more adverts (like the FAST one) on the TV/posters in GP waiting rooms etc around deconditioning/impact of being in hospital unnecessarily, we need it to become part of everyday discussion amongst the public #physiotalk |
| Ian Tyrrell @IanTyrrell5 @dementia_physio @_JoeMiddleton @ClaireOCPhysio @physiotalk @HealthPhysio @KVangucci Knew you wouldn’t let me down! #physiotalk |
 | Ann-Marie Riley 💙 RN @AnnMarieRiley10 @cathhoppo @ClaireOCPhysio @lynseyferguson6 @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio Yes I did 😊 happy to share how this was done at NUH if of interest to anyone #physiotalk |
| physiotalk @physiotalk RT @lindzOT: @physiotalk I would love to see more adverts (like the FAST one) on the TV/posters in GP waiting rooms etc around deconditioni… |
| Philippa Leishman @Leishm1Philippa @DawnScull @AnnMarieRiley10 @_JoeMiddleton @racheldphysio @Jo_burns27 Great! Quite nice I haven’t had to do one for it 🤗🤗🤗 #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @lindzOT @physiotalk This is a fabulous idea!! How do we make this happen? #physiotalk |
| Claire O' Connell @ClaireOCPhysio @IanTyrrell5 @dementia_physio @physiotalk @_JoeMiddleton @HealthPhysio @KVangucci Yes agree.. Very frustrating when you have put a lot of time into making the discharge the most appropriate for that patient and then having that to read "failed d/c" when they are readmitted. #physiotalk |
| physiotalk @physiotalk Wow - thats an hour gone! #physiotalk |
| Lynsey MacD-Ferguson @lynseyferguson6 @chrisarmitage80 @physiotalk These do happen. Its important in these cases a genuine apology is given. Then it’s how we learn from this and do better the next time #physiotalk |
| katie taylor @Katie_tayls @IanTyrrell5 @physiotalk Definitely this, risks of deconditioning and infections #physiotalk |
| Joe Middleton @_JoeMiddleton #physiotalk https://t.co/Ac9wEtazZC |
| Jennifer Kirby @FrontDoorPhysio @physiotalk Those vital conversations with family and carers, ensuring they too appreciate that although their mum does fall sometimes, she’s happy day to day; she always wanted to stay at home and remain as independent as she could for as long as she could (when that’s the case!)#physiotalk |
| Claire O' Connell @ClaireOCPhysio @AnnMarieRiley10 @cathhoppo @lynseyferguson6 @lauraakelly80 @SteffiBailey @physiotalk @dementia_physio @AnnMarieRiley10 yes this would be great if you could share #physiotalk |
| physiotalk @physiotalk Please keep on chatting - we seem to have hit a nerve with your thoughts on positive risk taking! #physiotalk |
| Christine Armitage @chrisarmitage80 @lindzOT @physiotalk This might need to be balanced with the genuine current Covid issue of ensuring people are accessing care including hospital when needed, so again a balancing act! #physiotalk |
| physiotalk @physiotalk RT @_JoeMiddleton: #physiotalk https://t.co/Ac9wEtazZC |
| Joe Middleton @_JoeMiddleton @physiotalk That is never the hour!!!!!!! #physiotalk |
| Claire O' Connell @ClaireOCPhysio RT @_JoeMiddleton: #physiotalk https://t.co/Ac9wEtazZC |
| Katie the Dementia Friendly Physio @dementia_physio @physiotalk It's been fabulous to hear everyones thoughts on such an important topic, thank you to everyone who has given their valuable time to this!! #physiotalk |
| Catherine Hopkins @cathhoppo @physiotalk Family/carer expectations, other MDT members being less open to considering looking at risk differently - worry about their pin/registration, resources in the community; their (non)existence/own stance on risk, the 'failed d/c' label on re-admission #physiotalk |
| physiotalk @physiotalk @_JoeMiddleton And 3 minutes... #physiotalk |
| Emma Hibbs @emmahibbs23 @physiotalk I often have quite candid discussions with pts/family/carers about managing risk, that we can’t eliminate it but mitigate where possible. Explaining the approach and reasoning behind it as well the outcome/pt choice. #physiotalk |
| physiotalk @physiotalk Fantastic chat this evening...thank you to all of you who joined in. If you missed it we will post the transcript later on this evening. Thank you to our guest host @dementia_physio for the questions and @JanetThomas47 @spiteri_anna from the #physiotalk team. |
| physiotalk @physiotalk @dementia_physio And thank you for your input! #physiotalk |
| Katie the Dementia Friendly Physio @dementia_physio @_JoeMiddleton @physiotalk Oh my goodness this is the best thing I have ever seen #physiotalk @KVangucci |
| ThePhysioBack @physio_back RT @_JoeMiddleton: #physiotalk https://t.co/Ac9wEtazZC |
 | JIMD @JorgeIMartinezD 👌 |
| Philippa Leishman @Leishm1Philippa @lindzOT @physiotalk Absolutely!adverts are so wasted on products! Health promotion and health culture should be on there. I don’t think medical models helps where results of scans/xrays either don’t get told to pts or long waits. Pts aren’t facilitated to take ownership of their health #physiotalk |
| physiotalk @physiotalk @dementia_physio And remember if YOU want to suggest a chat topic we are only a tweet or a DM away! #physiotalk |
| Claire O' Connell @ClaireOCPhysio @lindzOT @physiotalk Yes a TV ad to remind people of the risks of a sedentary life.. Could target a large variety of the population.. #physiotalk |
| Lindsay Sanders @lindzOT @chrisarmitage80 @physiotalk Absolutely, it’s how we can help people to understand when they do need to be in an acute bed vs when their health condition can be managed perhaps by other teams in the community #physiotalk |
| Philippa Leishman @Leishm1Philippa @lindzOT @dementia_physio @physiotalk @RoyalFreeNHS We have the rights to get ours on the screens but ran into trouble where every surgery uses different platforms (or something techy like that 🤷♀️) #physiotalk |
| Joe Middleton @_JoeMiddleton @physiotalk @dementia_physio @JanetThomas47 @spiteri_anna Thanks for hosting such an important topic @dementia_physio. Thanks to @JanetThomas47 and @spiteri_anna for facilitating the discussion, and for being particularly tight on the hashtag watch!!! #physiotalk |
| Claire O' Connell @ClaireOCPhysio RT @dementia_physio: @_JoeMiddleton @IanTyrrell5 @HealthPhysio @physiotalk @KVangucci shared this with me the other day- 'It's not a failed… |
| physiotalk @physiotalk @_JoeMiddleton @dementia_physio @JanetThomas47 @spiteri_anna We keep our beady eyes on all tweets! #physiotalk |
| Nikki Walker @nikkiwphysio RT @dementia_physio: @_JoeMiddleton @IanTyrrell5 @HealthPhysio @physiotalk @KVangucci shared this with me the other day- 'It's not a failed… |
| Catherine Hopkins @cathhoppo @physiotalk By being an open & safe forum to challenge norms/habits, by getting on board when people try to do things differently, by collectively working together to create better MDT connections with community colleagues - they need to embrace risk too #physiotalk |
 | Jonny Ford @Jonny_Ford Like this 👌🏼 |
| Katie the Dementia Friendly Physio @dementia_physio @lindzOT @physiotalk @RoyalFreeNHS I'm up for this if you are!! I'm currently off with Covid, but when I'm back I'll catch up with you about it!! #physiotalk |
| Joe Middleton @_JoeMiddleton If you have never done it and you have a particular topic you are passionate about, just give it a go! It is strangely exhilarating!!! #physiotalk |
| Sally Howard @salhowardphysio @dementia_physio @FrontDoorPhysio @physiotalk There’s the incentive to get home which can = that extra bit of effort to demonstrate independence...but a lot of people behave differently when not being observed. I want my patients to go home but want them to stay home, therefore ax at home key #physiotalk |
| physiotalk @physiotalk RT @_JoeMiddleton: If you have never done it and you have a particular topic you are passionate about, just give it a go! It is strangely… |
| Lindsay Sanders @lindzOT @physiotalk @dementia_physio @JanetThomas47 @spiteri_anna Thanks all! Im on annual leave this week but feel like I’m raring to go discharge some risky patients from ED now 😂 #physiotalk |
| ThePhysioBack @physio_back @physiotalk What a fantastic hour. Wanted to contribute more but didn't want to miss a tweet. So many notes taken. Thank you to everyone for your expertise and thoughts. #physiotalk |
| Tom Meredith @Tom_B_Meredith @physiotalk Advice and information on deconditioning is a bigger for me. I also think strong evidence of contingency planning also helps breed confidence. Highlighting the clients choice in the situation also goes a long way... back to positive risk taking to enable choice. #physiotalk |
| Jennifer Kirby @FrontDoorPhysio @dementia_physio @salhowardphysio @physiotalk Maybe: -they’re just that desperate to get home -they’ll let their usual carer do everything for them -memory problems -alcohol -not taking meds correctly -not eating/drinking well We can address some of these, not all! #physiotalk |
| Philippa Leishman @Leishm1Philippa @lindzOT @dementia_physio @physiotalk @RoyalFreeNHS Hopefully! Although for us it was all of them using different programmes so if that’s changed 🤞🤞🤞 @PhysioWvt are continuing to pursue it so hopefully we’ll get there!! #physiotalk |
| Philippa Leishman @Leishm1Philippa @DrLindaDykes will like this one!! |
| Lindsay Sanders @lindzOT RT @HealthPhysio: @physiotalk The belief that things can be completely 'safe' is a common misconception I find- from both clinicians, patie… |
| Catherine Hopkins @cathhoppo @physiotalk National comms on importance of active ageing & what normal ageing looks like ie falling is normal, frailty isn't inevitable supported by research into acute deconditioning, how to treat it - some hard hitting stats. Included on curriculum of HCP, Nurses, medics etc #physiotalk |
| Lindsay Sanders @lindzOT Love this. I actually think we should stop using the word safe altogether. I actively try to avoid using it, what does it even mean?! #physiotalk |
| Sheila Doughty @SheilaDoughty @scft_ahp check out the transcript from this later. Lots of interesting discussion and ideas to take forward. |
 | Abi Coller @abimc5 Interesting discussions on @physiotalk tonight about positive risk taking and education #frailty #physiotalks |
| Sheila Doughty @SheilaDoughty Something to think about? |
 | emma moore @emma_l_moore @IanTyrrell5 @dementia_physio @lindzOT @physiotalk I work in a community team and carry out d2as and we often support patients who you'd be horrified at on the ward but need their own environment to manage/thrive. Not always pretty but it's their way! #physiotalk |
| ThePhysioBack @physio_back @lindzOT This just made me realise that I used "safe" today. Tomorrow i may try "be able to manage as independently as possible"? #physiotalk |
| Tom Meredith @Tom_B_Meredith @physiotalk @dementia_physio @JanetThomas47 @spiteri_anna Thank you all, really informative. Such a important topic. @EstherClift thanks for the heads up on this, really great conversations and so brilliant to see so many passionate, client focused professionals coming together to learn. #physiotalk |
 | Justine Musiime - MCSP MSc MPH @JustineMusiime @physiotalk Having a strong desire to practice backward chaining with a patient in their own home, then succumbing to the strong desire not to take the risk just in case they can't get off the floor, as you would then have to phone the ambulance to get them off the floor! #physiotalk |
 | Gerardo Viveros RGL. @gerardo_viveros RT @JmNunezSilveira: 🚨Asincronias: Breath stacking, ¿Conocen los 3 tipos de Breath stacking? Video completo en 👉🏻https://t.co/lfKV0KT6d9… |
 | Lisa Webb @lisawebbOT RT @HealthPhysio: @physiotalk I don't believe 'safe care' is a sensible goal as it's unattainable. I think we should aim for effective care… |
| Lindsay Sanders @lindzOT 🙌🏻 #preach (thanks Joe, this is going in the MDT room!) |
| Ian Tyrrell @IanTyrrell5 @emma_l_moore @dementia_physio @lindzOT @physiotalk Nothing shocks me these days! I often say my assessments are not realistic and should be done at home! Often because relatives say ...”they don’t walk like that at home” always think the best place for the large majority of people is at home! #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 @IanTyrrell5 @dementia_physio @ClaireOCPhysio @physiotalk @_JoeMiddleton @HealthPhysio @KVangucci Great thread! #physiotalk |
| Katie Vangucci @KVangucci @dementia_physio @_JoeMiddleton @physiotalk Oh wow this is amazing! #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 @IanTyrrell5 @physiotalk @dementia_physio @lindzOT I love love love this #physiotalk It's like telling me I can't ride my mountain bike in case I fall off! |
| Jennifer Kirby @FrontDoorPhysio @salhowardphysio @dementia_physio @physiotalk Definitely. I’m lucky where I am that we have access to ‘urgent’ care and therapy input on discharge. I’ve also worked in similar services in the past. That reassurance and ‘safety net’ and allows so much more positive risk taking #physiotalk |
| Dr Michelle Bull 💙 @MichelleBull4 @Tom_B_Meredith @physiotalk @dementia_physio @JanetThomas47 @spiteri_anna @EstherClift Thank you for such a great #physiotalk - lots of food for thought |
| Justine Musiime - MCSP MSc MPH @JustineMusiime @physiotalk Public health promotion messages raising awareness about #frailty & #falls. #physiotalk |
| KB @KBNeuroinfo RT @_JoeMiddleton: #physiotalk https://t.co/Ac9wEtazZC |
 | JE Barnard @J_E_Barnard #MECFS #Physiotalk #LongCovid https://t.co/IDRIbkH2u6 |
| Justine Musiime - MCSP MSc MPH @JustineMusiime @physiotalk Maybe have a positive message resource pack about ageing well that gets given to people by their GPs or through their work places on retirement while their frailty score is still very low. #physiotalk |
| Lindsay Sanders @lindzOT @IanTyrrell5 @emma_l_moore @dementia_physio @physiotalk #homefirst!! Always! #physiotalk |
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