Mrs Joanne Crowley1, Mrs Sheridan Guyatt1,2
1Mater Health Services, South Brisbane , Australia, 2Universtiy of Queensland , St Lucia, Australia
Across Australia and worldwide, maternity hospitals have successfully introduced enhanced recovery caesarean birth models of care, aiming for new mothers to discharge home approximately 24 hours after Caesarean birth.
In 2018 Mater Mothers Hospital introduced their own Enhanced Recovery Caesarean Section (ERCS) model of care, implemented by a multidisciplinary team. Key to the success of this program is early mobilisation (usually within 4-6 hours). In addition to standard post-operative care, preoperative physiotherapy intervention was identified as an opportunity to optimally prepare patients for early mobilisation and successful facilitation of a 24-hour discharge.
Initial attempts to provide preoperative physiotherapy care face-to-face proved inefficient and resulted in inconsistent patient care. The A3 Thinking Tool for problem solving was used to investigate alternatives that were effective, timely and efficient. Electronic health (eHealth) was identified as an option for providing preoperative physiotherapy. Women participating in the ERCS program were sent an email with written, pictorial and video attachments in the week prior to their delivery that they were able to access in their own time. Patient outcome data was collected from care pathways and within physiotherapy treatments.
- High patient acceptability of pre-operative physiotherapy delivered via eHealth methods
- Cost effective with reduced physiotherapy occasions of service and decreased length of stay
- Effective care outcomes with 61% of women mobilised within 6 hours and reduced use of schedule 8 medication (oxycodone)
- Successful implementation of Physiotherapy eHealth and subsequent expansion of material sent to patients to include a multidisciplinary inpatient care guide.
This quality improvement project demonstrates that implementing an eHealth model of pre-operative physiotherapy care is an acceptable, effective and efficient treatment option for this group of patients and has the potential to extend into additional clinical caseloads in the future
Jo Crowley is an experienced physiotherapist having worked for many years in both the private and public sectors in Queensland. For the last 10 years she has worked primarily in women’s health in clinical and team leader roles within Mater Mothers and Mater Mothers Private Hospitals. She has a passion for providing quality obstetric care to women in both the inpatient and outpatient setting. She also enjoys working with multidisciplinary teams in providing antenatal education in community based outreach clinics to vulnerable obstetric populations.