About Nasreen Sau
Nasreen is a specialist physiotherapist working at Royal National Orthopaedic Hospital in Stanmore. She studied Physiotherapy at Coventry University graduating in 2012 and worked around Leicestershire in Musculoskeletal Outpatients for four years before moving to London. Nasreen’s area of clinical expertise is in management of shoulder instabilities, peripheral nerve injuries and dislocation management. She is interested in developing her research skills and is currently involved with a project in digitalisation of rehabilitation.
Problem: The problem we are trying to solve is how to best incorporate digital technology across therapies and be in sync with current technological advances that could improve the quality of care delivered. To self-empower & engage patients so they are actively involved in their rehabilitation.
Solution: One way to gain increased patient engagement is through the use of gamification of their exercise program. We have purchased the MIRA exergames software and trialled with a cohort of paediatric inpatients whereby they receive extra exercise sessions playing on the MIRA as part of their rehabilitation showing some initial positive results.
Scale of project: The scale of this project is to train 80% of the staff amongst 7 clinical teams. It is anticipated that further project development will expose more patients to this technology to enhance their clinical care.
Use: The initial usability study was done with 20 patients with a traumatic shoulder instability. The therapies department on average have up to 3000 out-patient contacts and 5000 in-patient contacts per month for physical therapy and occupational therapy rehabilitation. There are 150 clinicians who deliver this care.
Desired impact: The end goal is to provide an innovative way to exercise keeping with the current concept of digital technology. With the installation of technology in the new hospital at Royal National Orthopaedic Hospital Trust patients now have access to monitors and entertainment systems at their bedside. Patients can then access MIRA by their bedsides encouraging them to be more active and responsible for their rehab outside of dedicated therapy time. It can also be an adjunct in physiotherapy to engage patients to exercise with a possible home version available in the future. All the therapy staff will have been trained to use the software by the end of January 2019 and provided with protected time and opportunities to trial the software with appropriate patient groups. We have purchased two units of MIRA which is available for all staff to use. Further units could be purchased if more demand is identified with increased usage.
Progress to date: At the start of the programme, not many of the therapists were using the innovation or recommending it to patients. There were some logistical and technical challenges and some practical issues around the ease of login. Nasreen and her team had completed the staff training. Adoption was slow between May and August. However, as at December 2019, it was being used in 2 exercise classes weekly for 8-10 patients. In addition, it has also been picked up by the Sarcoma team who proactively reached out.
“I joined the Fellowship programme because I started a digital project with no previous experience. The mandatory 2-minute project updates that we had to give at the start of each learning day gave me the most value. I’d never done any public speaking before and this discipline helped me to deliver my audit presentation at work. My manager commented on how my presenting ability had improved.
During the programme the confidence I built around presenting has translated into me delivering several presentations: one for the Physio Research Society Conference to 75-100 people and to different internal teams reaching 150 stakeholders. Part 1 of my abstract for the project has been published in the International Journal of Rehabilitation (June/July). A research paper I have co-authored has been submitted, as of December 2019, was in the in the process of being approved for publication in the Digital Health Journal.
The programme has helped me to develop my ability to think strategically by looking at the big picture. I am identifying barriers a bit earlier and anticipating them. My manager has observed that I am thinking differently now, I prepare more rather than being reactive.”Nasreen Sau