Comments on: Clinical Risk vs. Clinical Need: managing workload and throughput

By: Mark Harrison

Mark Harrison — Thu, 13 Jan 2011 23:56:44 +0000

I work within a trust that has adopted the care aims approach, and I am now undertaking training in order that I can train staff new to our trust.
I have been usung the model/approach for approximately 9 months and find that it is enabling our team to manage referrals more efficiently (i.e. reduce inappropriate referrals), manage patients expectations more easily (by patient centred, transparent goal setting with a clear care aim) and facilitating timely discharge from our service. For Clare who asked about assessment tools, I am trialing Therapy Outcome Measures as both a baseline assessment and outcome measure, its domains include both medical and social aspects of function. e.g. impairement and participation are two. By the way, I am an Occupational Therapist on a Falls Prevention Service and address environmental, cognitive, ADL and confidence issues.

By: arianna

arianna — Wed, 25 Aug 2010 13:52:50 +0000

This comment is directed to Alison – I wonder if you might leave contact details – I’m interested in finding out more about your research with SLTs and the Care Aims approach, thanks you can contact me at admin@afasicscotland.org.uk

By: Rhiannan Walton

Rhiannan Walton — Tue, 16 Mar 2010 22:21:54 +0000

Thanks for the great question Clare. I’ve written a follow up post here:

http://therapyideas.org/blog/2010/03/16/care-aims-education/

By: Care Aims in education vs. medical model — Therapy Ideas blog

Care Aims in education vs. medical model — Therapy Ideas blog — Tue, 16 Mar 2010 22:20:38 +0000

[…] Grace raised a great question in response to my post from 2009, Clinical Risk vs. Clinical Need: managing workload and […]

By: Clare Grace

Clare Grace — Thu, 11 Mar 2010 11:33:27 +0000

Hi Rhiannan and Lisa,
Our Trust has undertaken the 2 day training and we are about to have our follow up day in April. I have been given the lead in my service to help start implementing Care Aims across the SLT service. I am trying to make links with other services going through this process – so it was great to find this blog!
We are undertaking case discussions at the minute – and mapping them out against the ‘What is my Duty of Care to Referred people’ flow chart. We look at a new referral and guess predictatvely where it will go, then we discuss an older case and look retrospectively how it would fit.
My biggest conundrum at the minute, is that the risk assessment tools are very medical model – and don’t seem to reflect anything within the tools/structures of education – and 80% of our caseload is working into an educational setting – any thoughts or ideas would be greatly appreciated.
Clare

By: Lisa

Lisa — Mon, 08 Mar 2010 16:38:52 +0000

Hi Rhiannan,

Personally I find question 5 the most difficult to answer but also the most useful! I usually think in terms of whether a case is likely to be short medium or long term but am aware this is still very subjective!

Hope you do find answering the questions useful. Let me know how you get on and what you find / do not find useful, or any alterations you made.

Lisa

By: Rhiannan Walton

Rhiannan Walton — Sun, 07 Mar 2010 15:25:32 +0000

Hi Lisa,

Thanks for your comment. Those questions look really useful.

I particularly like question 5!

We are re-establishing peer supervision, so I will take your questions along and try them out.

By: Lisa

Lisa — Tue, 23 Feb 2010 16:40:12 +0000

The service I work in is has implemented some of Malcomess’ ideas too.

As a result of the training we now meet with peers to analyse our caseloads. We ask ourselves the following questions in order to help us reflect on our caseloads using Kate Malcomess principles:

1.What is the patient’s current status e.g. regular therapy, review etc.?

2.When was the patient last seen?

3.If the patient was last seen more than 6 months ago, what are the clinical reasons for them still being current on the caseload?

4.When will the patient be seen again?

5.When is the patient planned for discharge?

I have found this really helpful for thinking about clinical risk vs clinical need and maximising throughput. Our service preferred to answer these questions rather than use the grid system recommended by Malcomess.

By: Rhiannan Walton

Rhiannan Walton — Sun, 19 Jul 2009 19:13:59 +0000

Hi Alison,

Thanks for your comment. That sounds interesting. What types of questions are you asking? Maybe we could post them up here.

The service I work in is just starting to implement some of Malcomess’ ideas, I’d be happy to help out.

By: Alison

Alison — Thu, 16 Jul 2009 13:12:52 +0000

I’m currently doing some research about SLTs experiences of using the Care Aims Model. Would be interested to hear others views