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A comparison between reported therapy staffing levels and the department of health therapy staffing guidelines for stroke rehabilitation: a national survey.

McHugh G, Swain ID - BMC Health Serv Res (2014)

Bottom Line: Only 42% of units analyzed reached the DoH guideline for physiotherapy and fewer than 16% of the units reached the guideline for speech & language therapy.By contrast, 84% of units surveyed reached the staffing guideline for occupational therapy.However, a post-hoc analysis highlights this as an irregularity in the DoH guidelines, revealing that all therapies are challenged to provide the recommended therapy time.

View Article: PubMed Central - HTML - PubMed

Affiliation: Bournemouth University, Talbot Campus, Poole, Dorset, England. gabrielle.mchugh@alumni.unbc.ca.

ABSTRACT

Background: This study compared reported staffing levels for stroke care within UK in-patient stroke units to stroke strategy staffing guidelines published by the UK Department of Health and the Royal College of Physicians. The purpose was to explore the extent to which stroke teams are meeting recommended staffing levels.

Method: The data analyzed in this report consisted of the detailed therapist staffing levels reported in the demographic section of our national survey to determine upper limb treatment in stroke units (the ATRAS survey). A contact list of stroke practitioners was therefore compiled primarily in collaboration with the 28 National Stroke Improvement Networks. Geographic representation of the network areas was obtained by applying the straight-forward systematic sampling method and the N(th) name selection technique to each Network list. In total 192 surveys were emailed to stroke care providers around England. This included multiple contacts within stroke teams (e.g. a stroke consultant and a stroke co-coordinator) to increase awareness of the survey.

Results: A total of 53 surveys were returned from stroke teams and represented 20 of the 28 network areas providing 71% national coverage. To compare reported staffing levels to suggested DoH guidelines, analysis was conducted on 19 of the 37 inpatient hospital care units that had no missing data for staff numbers, unit bed numbers, number of stroke patients treated per annum, average unit length-of-stay, and average unit occupancy rates. Only 42% of units analyzed reached the DoH guideline for physiotherapy and fewer than 16% of the units reached the guideline for speech & language therapy. By contrast, 84% of units surveyed reached the staffing guideline for occupational therapy. However, a post-hoc analysis highlights this as an irregularity in the DoH guidelines, revealing that all therapies are challenged to provide the recommended therapy time.

Conclusions: Most in-patient stroke units are operating below the DoH guidelines and are therefore challenged in providing the recommended amount of therapy and patient time to facilitate optimal functional recovery for stroke patients.

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Related in: MedlinePlus

Physiotherapy staffing per unit.
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Figure 1: Physiotherapy staffing per unit.

Mentions: FiguresĀ 1, 2 and 3 show reported staffing levels per unit for PT, OT and SALT per 10 beds compared to the DoH staffing assumption and the DoH staffing aspiration for each therapy per 10 beds. Each Figure reads as follows; the first box depicts the reported number of therapists for the 19 units, showing the median staffing WTE per 10 beds for each of the therapies. Box 2 compares therapist staffing levels that ought to be in each unit, based on the number of beds reported in the survey and the DoH staffing assumption. Lastly, box 3 compares staffing levels based on the reported number of beds and the DoH staffing aspiration. These figures reveal the disparity between the reported staffing levels in units and the DoH staffing assumption and the DoH staffing aspiration. Only 42% of units reach the DoH assumption for PTs per 10 beds, and fewer than 16% of units reach the guide for SALT. None of the units surveyed were near the aspirational levels of staffing.


A comparison between reported therapy staffing levels and the department of health therapy staffing guidelines for stroke rehabilitation: a national survey.

McHugh G, Swain ID - BMC Health Serv Res (2014)

Physiotherapy staffing per unit.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4060581&req=5

Figure 1: Physiotherapy staffing per unit.
Mentions: FiguresĀ 1, 2 and 3 show reported staffing levels per unit for PT, OT and SALT per 10 beds compared to the DoH staffing assumption and the DoH staffing aspiration for each therapy per 10 beds. Each Figure reads as follows; the first box depicts the reported number of therapists for the 19 units, showing the median staffing WTE per 10 beds for each of the therapies. Box 2 compares therapist staffing levels that ought to be in each unit, based on the number of beds reported in the survey and the DoH staffing assumption. Lastly, box 3 compares staffing levels based on the reported number of beds and the DoH staffing aspiration. These figures reveal the disparity between the reported staffing levels in units and the DoH staffing assumption and the DoH staffing aspiration. Only 42% of units reach the DoH assumption for PTs per 10 beds, and fewer than 16% of units reach the guide for SALT. None of the units surveyed were near the aspirational levels of staffing.

Bottom Line: Only 42% of units analyzed reached the DoH guideline for physiotherapy and fewer than 16% of the units reached the guideline for speech & language therapy.By contrast, 84% of units surveyed reached the staffing guideline for occupational therapy.However, a post-hoc analysis highlights this as an irregularity in the DoH guidelines, revealing that all therapies are challenged to provide the recommended therapy time.

View Article: PubMed Central - HTML - PubMed

Affiliation: Bournemouth University, Talbot Campus, Poole, Dorset, England. gabrielle.mchugh@alumni.unbc.ca.

ABSTRACT

Background: This study compared reported staffing levels for stroke care within UK in-patient stroke units to stroke strategy staffing guidelines published by the UK Department of Health and the Royal College of Physicians. The purpose was to explore the extent to which stroke teams are meeting recommended staffing levels.

Method: The data analyzed in this report consisted of the detailed therapist staffing levels reported in the demographic section of our national survey to determine upper limb treatment in stroke units (the ATRAS survey). A contact list of stroke practitioners was therefore compiled primarily in collaboration with the 28 National Stroke Improvement Networks. Geographic representation of the network areas was obtained by applying the straight-forward systematic sampling method and the N(th) name selection technique to each Network list. In total 192 surveys were emailed to stroke care providers around England. This included multiple contacts within stroke teams (e.g. a stroke consultant and a stroke co-coordinator) to increase awareness of the survey.

Results: A total of 53 surveys were returned from stroke teams and represented 20 of the 28 network areas providing 71% national coverage. To compare reported staffing levels to suggested DoH guidelines, analysis was conducted on 19 of the 37 inpatient hospital care units that had no missing data for staff numbers, unit bed numbers, number of stroke patients treated per annum, average unit length-of-stay, and average unit occupancy rates. Only 42% of units analyzed reached the DoH guideline for physiotherapy and fewer than 16% of the units reached the guideline for speech & language therapy. By contrast, 84% of units surveyed reached the staffing guideline for occupational therapy. However, a post-hoc analysis highlights this as an irregularity in the DoH guidelines, revealing that all therapies are challenged to provide the recommended therapy time.

Conclusions: Most in-patient stroke units are operating below the DoH guidelines and are therefore challenged in providing the recommended amount of therapy and patient time to facilitate optimal functional recovery for stroke patients.

Show MeSH
Related in: MedlinePlus