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Cold weather alerts

From the winter vomiting virus to spring hay fever, summer heat strokes to autumn seasonal affective disorders (SAD); every season has its peak illnesses. Of course, any of these can occur at any time, but health professionals are aware that as the seasons turn so too do differing conditions come to the fore.

With that in mind, as health professionals just how do you prepare to meet the differing challenges which the changing of the seasons throws up? It’s not always easy. Whilst some conditions, such as SAD which is triggered by shortening day length, are fairly easy to predict; others may depend on more variable factors.

For example, whilst summer rains might initially help allergy sufferers by washing pollen out of the air, a couple of days later with plant growth having been triggered by the rain you may well find an increase in pollen or mould levels, leading to an increase in allergy presentations. Or to look at another scenario, winter slips and falls are far more likely to occur in icy conditions than on comparatively milder days.

What this adds up to is a need for weather to be taken into account in resource planning. Local forecasts may be of help here, especially when viewed alongside national resources such as the Met Office’s cold weather alert service.

Operating from 1 November to 31 March each year in conjunction with the UK Health Security Agency (UKHSA), the cold weather alert service aims to reduce the impact of severe cold weather on people’s health. It does so by not only predicting weather severity but also providing advice to individuals, communities and agency on how they should prepare and manage differing scenarios.

Building on an alert level 0 which looks towards all year round planning, four other levels look towards steps required to manage anything from mild winter conditions (Level 1) to a major weather incident (Level 4.) So, for instance, Level 2 looks for social and healthcare services to work to ensure that they are prepared to take swift action to reduce the risk of harm from a period of cold weather whilst Level 3 requires those agencies to take specific actions in order to protect high-risk groups.

At the time of writing we are facing alert level 1 in the three northernmost regions of England with alert level 2 across the rest of the country. The level 2 alert specifically warns of a “70% probability of severe cold weather between 1800 on Thursday 13 Jan and 0900 on Monday 17 Jan in parts of England. This weather could increase the health risks to vulnerable patients and disrupt the delivery of services.”

Information such as this helps health providers to create flexible solutions which can be triggered depending on need. Even something as simple as being able to transfer phone calls to a virtual assistant service when demand is high could help with resource management. When the pressure is on to treat as many individuals as possible, the ability to outsource some routine administration matters such as phone answering or even the booking of appointments could just tip the balance towards effective care when it is most needed.

Patient Confidentiality

98.9% of doctors and 95.1% of nurses own a smartphone. There’s nothing particularly surprising in that, although it is ahead of the UK average; but what is perhaps surprising is that 92.6% of doctors and 53.2% of nurses find their smartphone to be useful or very useful in helping them to carry out their clinical duties.

That was the finding of a multicentre cross-sectional study which was recently published in BMJ Innovations. Whilst a proportion of smartphone use related to using the phone in place a more traditional ‘bleep’ the study also revealed that health professionals were routinely using apps, picture and text messages to send patient information to colleagues.

Whilst there is nothing intrinsically wrong in using smartphones to speed up communications, the study does raise concerns over the security of information which is being shared over unsecured media. In their conclusion, the study’s authors comment that “healthcare organisations need to develop policies to support the safe and secure use of digital technologies in the workplace.”

In truth, organisations which have yet to draw up policies relating to the safe use of technology are behind the times but it also has to be acknowledged that the speed of technological change may have caught out some healthcare practices. When the industry as a whole is talking about overarching concerns such as the safe storage and sharing of digital patient records on a countrywide basis, it is perhaps easy to overlook the fact that individual health professionals are using day-to-day communications to speed up treatment.

It certainly has to be acknowledged that the digital storage of patient records, the maintenance of electronic diaries, or even the sending out of appointment reminders by text have helped to smooth out patient communication and treatment pathways. But whether the data is being managed on a national level or within a specific health practice the importance of respecting patient confidentiality cannot be underestimated. That’s why our systems are set up to respect the privacy of your clients.

However securely data is maintained, at the end of the day security is a state of mind and it is up to every health professional to ensure that when they share information they do so with confidentiality and security in mind. As an NHS spokesperson, commenting on the survey, said “Apps and other online services offer powerful benefits to clinical practice but it’s vital that doctors and nurses know which ones are safe to use.”

When this article was originally written in 2015, the concern was over the safe use of digital records but the safeguarding of physical records should also not be ignored.  Reviewing this article in February 2017, reports have come to light of the ‘misplacing’ of some 500,000 NHS patient documents.  Early indications are that these were stored in a warehouse rather than being filed in patient records or sent to GPs.  There is no indication at present whether these records would have had a material impact on patient care but it does highlight the importance not only of patient confidentiality but also of ensuring that records are complete and up to date.

One Step Too Far

In our last article we commented on the way in which exercise regimes have moved on; with the emphasis now being on providing exercise and mobility training which not only suits individual pursuits but also the individual athlete. With the Rugby World Cup being very much in evidence at the moment, it’s a theme which we thought we would return to.

Aside from the numerous injuries which seem to have befallen the Welsh team, opening skirmishes have led to injury worries for numerous players. Some will be rested before being brought back into the fray later on in the campaign whilst for others their World Cup dream is already at an end.

The neutral observer may question why there are so many injuries when it comes to the big tournaments. Admittedly rugby is a game which begets injuries but it has to be asked whether there is an underlying reason for so many key players to become injured at the same time. Again the neutral observer may wonder whether it is simply that in rugby injuries are rife, but we only hear about them thanks to the increased publicity which world cups bring.

But there has to be more to it than that and whilst some injuries are simply down to the run of the game or bad luck, it has to be wondered whether others may be as a result of a desire to field the best team possible. This can lead to circumstances such as players who are carrying a minor injury being selected in the hope that they will be fit in time for the tournament, players ignoring slight niggles as they don’t want to miss out on the tournament, or even a bit of overtraining in a bid to be as ready as possible for a key match.

Whatever the reason, players who entered the tournament in hope are leaving it in pain; being forced to swap the field of glory for the physiotherapy table. As they depart they bring a lesson for all of us. It’s one thing to push yourself to the limits of your ability but take one step too far, be unrealistic in your expectations, and you will run the risk of harm.  We all like to think we can cope under pressure, we all like to think that we can just do one bit more and one bit more again but even those at the top of their game have their limitations.

In other words, sooner or later we will reach the limits of our abilities and when that happens we have to call on others for help. And that is not an admission of failure; it is simply an acknowledgement that when we are open to calling others on to our team, we can stretch just that bit further and do just that bit more.

For injured players, it will be the help of physiotherapists and other health and fitness professionals. For those same health professionals, it may be the help of administrators or assistants in areas such as booking and keeping track of appointments, maintaining virtual client records or simply in answering the telephone to avoid interruptions to client treatments.

Sportsperson or not, sooner or later we all come up against our limits. Getting the right help at the right time might just prevent us taking one step too far.

Taking Time Off

When you spend all of your time looking after the health of others, it can sometimes be difficult to take time to look after yourself. There always seems to be one more patient to help, one more report to write, one more bit of paperwork to file before you can step out of the office and into home life.

In this, health professionals are not alone. A recent report by Simply Business revealed that 20% of the UK’s small business owners say they can’t afford to take a single day off work this summer whilst a further 30% plan to holiday near home to keep an eye on their business.

In fact, this problem of work-life balance is seen in many countries. A recent report by German researchers revealed that working outside of core hours on tasks such as checking emails can limit the ability to feel detached from work, leading to higher levels of the stress hormone allied to a feeling of increased tiredness.

Whether working as a sole trader or in a small business it can sometimes be hard to see where you can turn to reduce the workload. The last thing you want to do is to reduce your client base as that will reduce income so instead it is tempting to save up all those administrative tasks for the evenings and weekends. Of course, there is the option of taking on a part-time member of staff to help with the workload, but this can be a tricky balancing act.

Obviously, if you have a regular volume of extra administrative tasks to complete then a new member of staff may well be the answer. However, when the workload is irregular then you may not be able to justify adding to your team on a permanent basis and temporary members of staff will always be around to answer the telephone when it is ringing and you are with a patient.

But there is another way. Virtual assistant services can help to reduce the workload by taking on tasks such as telephone answering, appointment booking and records and diary management. Better still, by using a virtual assistant service you gain the flexibility which you require. For example, you can switch telephones over to the virtual service when you are with clients or on holiday, switching them back when you are free to answer calls.

Tasks such as phone answering and appointment booking can easily intrude on daily business life and create a pressure point which can add to stress levels. Not having to answer the telephone when you are treating patients or meeting with clients, being able to access client notes online rather than spending time in preparing for meetings, even having someone to screen out unwanted sales calls can all make a difference to the working day and to peace of mind.

Of course, at the end of the day virtual assistant services can only go so far in helping to improve the work-life balance. The bottom line is that as a business owner you owe it to yourself, to your family and to your clients to take the time off that you need to refresh the mental and physical batteries. If you don’t, your work will suffer and that helps no-one.

From Sun Up to Sun Down

By the time that you read this article, the chances are that the US Masters golf tournament will be over and all of the speculation about whether Rory Mcllroy or one of the other front runners will triumph will have been answered. In the run-up to the tournament, apart from spotting potential winners, one of the main stories revolved around Tiger Woods and his return to the competition trail following treatment for injury from physiotherapists and other health professionals.

Commenting on his comeback Tiger Woods said “People would never understand how much work I put into it to come back and do this again, it was sun up to sun down.” His comments are hardly surprising, given the champion he once was.

Getting to the top in any walk of life requires a measure of determination and hard work and getting back to ones best after a set-back requires an extra measure of grit and courage.  But such courage is not simply confined to top sportspeople. The determination to improve, to get better, to overcome injury or other setbacks comes from within and can be found in all walks of life. It’s something which physiotherapists and other health professionals see on a daily basis. Octogenarians recovering from a hip replacement, children regaining the use of broken limbs following a fall, the middle aged recovering from a rather too strenuous gardening session in the spring weather; whatever the reason, when we set our minds to a task it is surprising how the results will follow.

It is one of the key motivators and rewards of being in the health profession; seeing others improve, watching them stretching themselves to the limit in a bid to return to fitness. It also can be one of the prime challenges; balancing people’s desire to return to ‘business as usual’ against their ability to recuperate. Get the balance wrong one way and overwork could lead to a setback. Swing the pendulum too far towards caution and the ability to return to maximum mobility could be lost forever.

Getting the balance right, deploying your professional skills to the benefit of patients is challenging but success can be personally rewarding. Discharging an individual from your care as they step out renewed to live as full a life as possible marks a success point in a busy profession. Sadly the procession of those in need is never-ending and physiotherapists, osteopaths, chiropractors and others could easily find themselves working from sun up to sun down in a bid to meet the ongoing demand.

Taking full advantage of time saving devices is one way to keep administration time down to a more manageable level. Electronic appointment booking, card payments, SMS text reminders, virtual assistant services; whatever the mix, finding ways to free up time will help busy health professionals to manage their day effectively. Who will win the Masters? We just don’t know but what we do know is that winning those everyday battles for fitness, fought by ordinary people of all ages, is for them every bit as important as any trophy could be.

On Your Feet Britain

On April 24th 2015 (29 April 2016) the Get Britain Standing campaign in association with the British Heart Foundation is challenging British workers to sit less and move around at work more whilst raising money for heart research. Studies have shown that even those who are active at some times in the day can still damage their long term health by sitting for prolonged periods during the day.

This means that the daily jog to work may have benefits on one level but if you then sit without moving for hours at a time you are in danger of developing heart disease, type 2 diabetes or even some cancers.

Released in connection with the challenge, a survey of office workers revealed that 45% of women and 37% of men spend less than 30 minutes a day on their feet at work and that more than half regularly eat lunch at their desk. Apparently sitting for long periods affects the way in which the body controls areas such as sugar levels, blood pressure and the breakdown of fat so the challenge is on to regularly stand up and walk around.

That doesn’t necessarily mean that work will suffer as we look to our health. Suggestions from the On Your Feet team include standing up to take phone calls, walking to a colleague’s desk instead of phoning or e-mailing them and having standing or walking meetings.

Having said that, there are some professions in which having the chance to sit down for a few moments would be welcome. For example, when health professionals are faced with a continuing parade of patients through their practice, any time spent away from treatment can easily be taken up in paperwork rather than in looking after oneself. Whether you stand up a lot and need to sit down or sit down a lot and need to stand up, taking a few minutes out every now and then can help to reduce stress levels as well as give the body a much needed change of position.

This means that anything which can be done to reduce time taken on routine paperwork is time which can be better spent, either on further treatments or on ‘me time’. Online bookings, card payments, electronic patient notes, automatic appointment reminders; the list of potential time savers goes on.

But the best thing is that not only do these measures save time, they can also help to smooth out the working day. For example appointment reminders help to reduce no-shows whilst electronic note filing saves all that time looking for misplaced records. Given the pressure that the health service is under, it is tempting to plough all of that saved time back into patient treatment.

However, in the spirit of ‘physician heal thyself’ it is important that health professionals take regular breaks in order to stretch and move around, or simply to unwind the mind. It is inevitable that over the course of the day fatigue may set in, but the more we can take time to refresh the better we will feel at the end of the day and the better and more focused treatment we are able to give to our patients.

The Get Britain Standing campaign wants is to stand up, sit less, move more. Whether we need to follow their advice or whether sitting for a few moments would be a blessing; the important thing is that the campaign makes us think more about how we approach our working day.

Business Spring Cleaning

The second week in March has sadly not lived up to the promise of the first with cold, wet and dull weather taking the place of sunshine. Nevertheless spring is well on the way and with it our thoughts turn to the annual challenge of spring cleaning.

No-one knows where the tradition of spring cleaning started. The practice has been shown to have roots in several ancient cultures but it is almost tempting to speculate that even back in cave dwelling times, ancient people stepped out from the crevices in the rocks which had given them winter shelter, sniffed the fresh air of spring and started to clean.

But there is a darker side to spring cleaning. As we vacuum and scrub, mop dusty floors and persuade over-wintering spiders to leave the home, the emergency services are poised waiting for the call. Every year, casualty departments are called on to treat those of us who thought that balancing on a rickety chair or table would be a good idea when cleaning windows or reaching high ceilings. Others will have to call on the services of physiotherapists or osteopaths to help sort out sprains and strains caused by repetitive movements such as overenthusiastic dusting or polishing.

With health professionals such as physiotherapists being stretched by all of these seasonal injuries, it may be time for them to carry out a little spring cleaning of their own. When we start out in business we tend to adopt coping mechanisms, working through processes which may cost us in time but save cash flow. With more mature businesses it may be time to spring clean some of these practices, bringing processes up to date.

For example, in the early days with few clients it can be a simple matter either to hope that they will turn up for appointments or phone them with a reminder.  Growing businesses which try to continue this practice may well be spending time on client reminders which would be better spent on treating a growing client base.  And in truth, what business nowadays can afford to operate under a model which allows for gaps in appointment times when clients fail to turn up. Simple remedies such as SMS text reminders, the availability of online booking and switching phones in busy times can free up a significant amount of time.

SMS text reminders also help to cut down on no-shows, but it still leaves businesses open to the possibility of a reduction in income, should clients fail to turn up for their appointments. One practice which can help to alleviate this problem is the taking of credit or debit card details at the time the appointment is made. When clients turn up for their appointments the card payment can simply be confirmed, considerably smoothing out the invoice/administration process. However, should clients fail to attend appointments; a no-show fee can still be taken in accordance with the health practice’s publicised tariff.

As we are looking at spring cleaning for efficiency, ask yourself if it is really necessary to have all of those paper records cluttering up the office?  Electronic filing can not only help to clear away paperwork, with patient records available at the touch of a button it can also help to save time when clients come to call.  It doesn’t take much to spring clean business processes, but health professionals may find that taking a little time out to review the way the practice is set up now could make a measurable difference in the future

‘Snow Joke if You’re Injured’

At the time of writing this article, a stunning photo has hit the headlines showing a skier making the most of the snow in the peak district. Taken under a clear blue sky and with the benefit of once in 20 year snow conditions; the picturesque scene could easily rival that at any ski resort abroad.

Elsewhere across the country it is a mixed picture. Whilst some are having fun building snowmen and throwing snowballs, others are simply faced with cold winds and ice. But whatever the weather, there is no doubt that winter, long postponed, has arrived at last bringing with it the usual mix of delight and disaster.

Whilst snow and ice may be fun for some, it can be no joke for those who fall prey to its deadly embrace. As cars slide on treacherous roads and pedestrians slip on pavements the list of sprains, strains and fractures can add to the usual winter woes packing out our casualty departments. Some may be quickly bandaged up and sent on their way but for others a long slow road to rehabilitation awaits.

It is a sad fact that the older we get, the longer our bodies take to heal and injuries such as a strain or pulled muscle which we mostly ignored when young can be devastating now.  And the longer we take to heal, the more other joints and muscles in our bodies seize up; bringing problems further along the line. For the elderly this can mean that even minor falls lead on to life limiting conditions. For example, slip over and hurt your ankle and by the time that it is well on the way to healing, the forced period of inactivity may well have led to knee, hip and back problems. Whatever the age, one of the solutions is to stay as active as possible and that means enlisting the help of a physiotherapist or other health or sports professional.

The trouble is that with winter slip and fall injuries adding to a list of winter sports injuries, whether from playing rugby or hitting the slopes, health professionals such as physiotherapists, osteopaths and chiropractors find that winter is a very busy time. With only a set number of hours in the day, in order to try and meet winter demands health professionals are turning to the internet and digital devices to help them to reduce administration time and maximise treatment times.

Working smarter not harder may be a cliche but it is one which has a basis in truth. Online appointment booking, automated SMS text reminders and electronic patient records all help to free up time which can then be devoted to patient treatment.  For those who prefer to retain a personal touch, switching telephone calls to a virtual assistant service means that patient calls can be answered in a professional manner without interrupting ongoing consultations; with the virtual assistant service making bookings via an online system.

Even something as simple as taking card payment details at the time of booking can help to cut down on missed appointments whilst simultaneously making it easier for client payments to be collected. These are all small changes but taken together they can make a measurable difference to the working day.

Snow may be beautiful to look at but when we fall prey to its embraces it is good to know that our physiotherapy and health services are on hand to help us to quickly heal.

Exercising Choice for a Fitter Health Practice

It’s January and that means only one thing; a host of fitness and diet related stories have hit the headlines. In a bid to either persuade us to keep those New Year resolutions, or to even make some belated ones, news media are leaping on any health related story they can find and putting it out there for our consideration.

Are we swayed by the headlines? Well perhaps some of us will use the research conclusions to kick start an improved lifestyle, but for others the exhortation to improve diet or fitness levels will merely be of passing interest and will have no effect on ingrained lifestyle patterns.

Actually when you stop to analyse some of these stories, the advice given generally only amounts to common sense. The study which concludes that a brisk daily walk, even if just 20 minutes, can add years to life expectancy is hardly surprising; although it was interesting to see that the research concluded that twice as many deaths a year are attributable to inactivity than to obesity. Similarly, a report which concluded that working as part of a team, either with a partner or with others, can help people to stick to lifestyle changes makes sense when you consider that a self-supporting team is less isolated than an individual.

But if some of the conclusions are simple common sense and may well lead to lifestyle changes, others may have varying measures of success. A report which suggests a correlation between wearing high heels and the chance of developing osteoarthritis may be unlikely to sway the majority of those who enjoy wearing shoes with high heels. On the other hand, a report which suggests that moderate alcohol consumption is linked to reduced heart failure risk may well be seized on by those who enjoy the odd drink but were feeling guilty about its affects on health.

In essence this is the beauty of having free will, and not just on health related issues. We can look at all of the advice and choose that which seems best to us. That’s why some businesses interrupt client conversations to answer the phone whilst others have set up a system which diverts phone calls to a virtual assistant. That’s why some businesses still file records by hand whilst others have embraced digital filing methods. And that’s why some health practices offer online booking and card pre-payment methods whilst others stick to phone bookings and collect the payment later.

Whatever the business, whether you offer one-to-one health consultations or regular pre-booked fitness classes, the key to success is to know your customer and offer a business model which will best meet their needs. Special offers and discounts are all very well in attracting new custom, but people won’t stay unless you offer them a level of service which encourages them to return time and time again and to recommend you to friends. So going back to one of our earlier examples, if your clients tend to have busy lives then online booking is a quick and simple way for them to make an appointment. On the other hand, if your client base is more elderly then they may feel more comfortable making telephone bookings.

No matter how seemingly strong the research, whatever the ‘experts’ tell us, at the end of the day all research and all ‘best practice’ advice is there to act as a guide.  What we do with it, how we turn advice into great customer service and a strong and fit health practice is up to us.

Redesigning Your Therapy Service

A discharge team working out of two West Midlands’ hospitals has been recognised with a national award for creating an integrated discharge process which includes a focus on early identification of appropriate therapy. The idea behind the scheme is simple but it has already reduced patient hospital stays by over 13% and saved the Trust around £2.5m.

Simply by giving therapists ‘trusted assessor’ status, patient assessments can start earlier, even before the patient has left hospital. Not only does this lead to the provision of a care plan which starts even before the patient has left the hospital, it also this means that seamless ongoing care can be provided.  With therapy plans already in place, patients can be discharged into home care far earlier than before. This in turn means that treatment is more focused, not only meeting the immediate needs of the patient but also their long term rehabilitation needs.

Prior to the inception of the integrated discharge process, patients would have to stay longer in hospital to ensure that they had recovered sufficiently well to enable them to be discharged into a home or other environment. Moreover, once they had been discharged they would have a period without treatment arguably at a time when treatment is most effective; having to wait for community assessment at home and potentially facing a relapse of their condition in the meantime. So not only do the new procedures save bed space they also help to speed up rehabilitation.

The idea of creating seamless and integrated processes is not just one which is confined to hospital discharge. When reports reveal that generally the health system is under some strain, anything which can speed up patient treatment and therefore recovery times is welcome. Health practitioners across the board are therefore looking for ways to cut down on administration and maximise treatment time.

Quite frankly, anything which can reduce the time spent on routine administration, and therefore non-treatment, time is to be welcomed. That is why practices such as SMS text messaging to remind patients of appointments, online booking and digitising patient records are becoming more widespread as health practitioners look to automate the non-treatment elements of their daily round.

For health practitioners who need to charge for their services secure card processing helps not only to smooth out cashflow but also saves time in sending invoices and chasing unpaid accounts.  And using the services of a virtual health receptionist means that patient treatments can run without interruption from multiple phone calls, leaving the health practitioner to provide therapy whilst others take the administration strain.

Thinking outside the box, thinking smart; whatever you call it the result is the same.  As health practitioners find new ways to leverage the advantages to be gained from technology and look anew at routine processes, they can make a measurable difference to ongoing patient treatments. As Physio Karen Lewis, one of the award winning West Midlands team said, receiving national recognition “really shows the value of physiotherapists leading innovative service redesign for the benefit of patients.”

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