Three hospitals globally have enabled patients to continue their rehabilitation remotely through the use of groundbreaking rehab technology, which was donated for use by its creators.
The National Hospital for Neurology and Neurosurgery (NHNN) in London, Mount Sinai Hospital in New York and Fondazione Don Gnocchi in Milan have all been given use of the Evolv Rehabkit, which allows the prescription of personalised telerehabilitation activities for people to complete remotely.
The initiative was a joint approach from medtech company Evolv, alongside Microsoft and ZOTAC.
The Evolv Rehabkit comprises a virtual therapy software platform called EvolvRehab, and the RehabKit hardware which connects to a television.
The system allows patients to perform exergames – video game-based exercises – which are prescribed by therapists who can remotely monitor patient adherence and performance through the system.
The NHNN is using the RehabKit in its Queen Square Upper Limb Neurorehabilitation Programme.
“We know that rehabilitation is vitally important for upper limb recovery,” says Professor Nick Ward, consultant neurologist who leads the programme.
“Repetitive training is one component, but it is often not motivating.
“We should be striving to create enriched environments for our patients to recover in, and the RehabKits are a great way of contributing to that in their own home.”
The Evolv RehabKit incorporates the Microsoft Azure Kinect DK, which uses computer vision and Artificial Intelligence to track patients’ movements, and a mini-gaming PC from ZOTAC.
Microsoft’s Azure cloud platform is used to securely host and share the experience, while Microsoft Teams allows patients and therapists to communicate quickly and easily.
Through the adoption of the technology, patients have been able to continue rehabilitation they would otherwise have potentially missed out on over the past year, jeopardising their longer-term prospects of recovery.
In New York, the Evolv RehabKits will be rolled out to a network of facilities for older adults, as part of a fall prevention programme supervised by the Abilities Research Center at Mount Sinai Hospital.
Fondazione Don Gnocchi, one of the largest not for profit organisations in the field of rehabilitation in Italy, plans to use their donated RehabKits to provide home care to patients with neurological conditions including stroke and Multiple Sclerosis.
“The pandemic has had a devastating effect across the world on patients receiving specialised rehabilitation, as well as on their families and care givers,” says David Fried, chief executive of Evolv.
“We wanted to help the medical professionals who are working tirelessly to continue treating their patients remotely under incredibly difficult circumstances.
“We are delighted that therapists can use our solution to provide telerehabilitation during this global crisis to support some vulnerable people in society directly in their own homes or out in the community.”
Quentin Miller, principal program manager for the Azure Kinect project at Microsoft, says: “We have an existing relationship with Evolv, so when they asked us if we wished to participate in this project, we didn’t think twice about it.
“Microsoft has been at the forefront of providing transformative solutions in the healthcare field providing remote services to patients during the period of the COVID-19 pandemic.
“We hope to help hospitals use our technology along with that of Evolv and ZOTAC to help open the door to telerehabilitation and drive innovation in patient care.”
Tony Wong, chief executive of ZOTAC, adds: “As a technology leader in gaming and computer hardware, we were pleased to utilise our unique line of mini PCs in a collaborative solution to drive this amazing telerehabilitation initiative to help those in need.
“This opportunity to utilise our mini pc and graphics card engineering expertise to work in tandem with Evolv and Microsoft was a natural fit as many of our mini pc solutions power many other technologies behind the scenes and this was another example of that.
“We couldn’t be happier to be a part of this solution as it helps to improve the lives of those directly and indirectly affected by the COVID-19 pandemic and we hope this collaborative technology solution will continue to aid healthcare organisations and their patients in many other ways long into the future.”
Review launched into end-of-life stroke care
End-of-life care after stroke and how current practice can be improved is being investigated in a new landmark study.
Hospital stroke units across the UK will be assessed to establish their current end-of-life care approach, and the views of health professionals, alongside patients and families will be sought in formulating the recommendations for best practice.
It explore current challenges around receiving and providing end-of-life care after stroke and will investigate what medical professionals, patients and carers consider both helps and hinders current levels of care.
The 18-month study is being supported by a grant of £142,626 and involves universities and NHS Trusts across the country.
It is being led by the UK’s largest nurse-led stroke research team at the University of Central Lancashire, whose School of Nursing is home to the only two nursing professors of stroke care in the UK.
“Despite medical advances, 21 per cent of stroke patients die within 30 days of having their stroke. High quality end-of-life care and support after stroke is therefore crucial,” says Dr Clare Thetford, senior research fellow from ULCan’s School of Nursing.
“However, stroke is different to other conditions, and can make end-of-life care complex.
“There is a lack of education and guidance for healthcare professionals responsible for providing this care. This may cause inadequate, inappropriate or delayed care and support.
“We will explore what specific challenges stroke may create, and how the many recent changes to general end-of-life care might work with stroke patients.”
The National Institute for Health Research Programme Development Grant will see UCLan and Lancashire Teaching Hospitals NHS Foundation Trust (LTHTR), based in Preston, collaborate with partners including Oxford University Hospitals NHS Foundation Trust, Canterbury Christ Church University, University of Nottingham, Poole Hospital NHS Foundation Trust, University of Exeter, alongside a dedicated patient and public involvement group.
Professor Liz Lightbody, who is leading a National Stroke Workforce group for end of life care, on behalf of Health Education England, says: “There is a view that providing end of life care is the role of specialist palliative care teams, but this is not the case.
“Good quality end-of-life care is everyone’s business, all staff involved in caring for patients following a stroke should have the knowledge and skills to provide compassionate and sensitive end of life care.
“LTHTR is committed to providing mechanisms to translate research evidence into practice and thereby influencing improvements in the quality of care. It is providing a pivotal role in the transformational development of stroke services across South Cumbria and Lancashire and will ensure the results from this research are implemented into practice.
“Together we are at the forefront of new innovations in healthcare, so I am delighted that we are involved with this research and that local patients can benefit from access to emerging new treatment for strokes.”
Nurses to establish specialist centre in Nigeria
Two nurses from a care and rehab community are using their 20 years of experience with the provider to open a specialist care centre in their native Nigeria.
Isaac and Nikki Ajibade, two of the longest-serving members of staff at Askham Village Community, are establishing an 18-bed centre in Nigeria which will provide nursing and dementia care, with future plans to expand into neuro support.
The couple are using Askham’s community approach in creating their own centre, and will use their two decades of experience with the provider to help them establish and develop their new project.
“We will be using Askham as a source of inspiration for our approach – with a key focus being on the real sense of togetherness we feel here,” says Isaac, who met his wife at the school of nursing in Nigeria in 1976.
“Askham’s owners care for the place, for the staff, for the residents, and it’s this we want to emulate ourselves in Nigeria.
“To care for people, you need to be compassionate. People need help and I’m always very happy when I’m helping people.”
The couple will retire from Askham, near Doddington, at the end of the month to begin work on developing their centre in Nigeria, which is already built.
Isaac is currently Askham’s longest-serving lead nurse, who specialises in long-term degenerative conditions of young people, and Nikki is a specialist nurse in dementia care.
Both have played significant roles in the development of Askham Village Community. Isaac joined Askham in 2012, with his current role seeing him manage Askham Place, one of the five independent care units that make up Askham.
When he first joined, there were only three units, but in his time there the care community has continued to expand its offering, broadening its expertise to cater for ever more resident and patient needs.
The couple also say they regard their colleagues and residents at Askham as members of their extended family, and last Christmas, their children and grandchildren – who live and work in the US, Ghana and Nigeria – all visited Askham during a holiday to the UK.
“In life, we are in stages. The main thing is to move when you are strong, and when you can go out and about and do the things you want to,” says Isaac.
“We feel we have achieved three quarters of what we want in life! My children are grown and I’m happy they’re all in good places, so the next thing is to go and enjoy the latter part of our lives where we can do good and rewarding work that brings us joy.”
Aliyyah-Begum Nasser, director at Askham, says: “Isaac and Nikki are Askham institutions. They have been with us for many years and to be honest I can’t imagine Askham without them. Their legacy will be here for years to come.
“Ever since they first started with us, they have always been part of the life and soul of Askham. I have so many fond memories, particularly when we would celebrate the diversity at Askham through international days and Isaac would always come in his native Nigerian attire, much to the delight of the residents.
“As lead nurse of Askham Place for almost a decade, he has witnessed the many high and lows of working in social care, but has always remained focussed on providing the very best care for his residents.
“Nikki is just as dedicated to her dementia residents in Askham House and her personality shines through in all she does. Just like a proud motherly figure, she runs a tight ship but always makes sure everyone is smiling.
“Most recently, during the height of the COVID-19 pandemic, she has been what can only be described as a true soldier; motivating her team and ensuring residents were comfortable amidst incredibly trying circumstances.
“On behalf of everyone associated with Askham, we can’t thank both of them enough for all the vulnerable people they have provided excellent care for, and the countless staff they have empowered and led and supported over their years here.
“They’re so dedicated to our residents, and we know they will apply that same dedication to their endeavours in Nigeria. We’re all excited to see it come to fruition and will be doing all we can to support it from afar and we wish them all the very best.”
Specialist hospital expands capacity
A hospital which supports people with brain injuries and degenerative neuropsychiatric conditions has invested to increase its capacity, bringing a further 12 much-needed beds.
St Peter’s Hospital in Newport now offers 51 beds across single-gender units, which provide person-centred assessment, specialist treatment and nursing care for men and women.
The additional beds come after a significant investment from specialist care provider Ludlow Street Healthcare, which owns and runs St Peter’s Hospital.
In addition to the 12 new en-suite rooms, a new family room and modern communal area have also been created, increasing provision for patients and their families.
St Peter’s is known for the multi-disciplinary team is has on site, including psychologists, psychiatrists and an extensive group of therapists including dietetics, physiotherapy and speech and language specialists.
It is committed to pursuing a therapy-based model of care, which can reduce patients’ need for a primarily drug-based pharmacological approach.
“Caring for and treating people with degenerative neuropsychiatric conditions and ABI is a very specialist area which requires expert knowledge and a lot of time,” says Dr Grzegorz Grzegorzak, consultant psychiatrist at St Peter’s Hospital.
“There is an urgent need in Wales and the UK as a whole for more specialist facilities like ours. Extending our facilities allows us to give immediate help to more people, delivering more positive outcomes.”
Work began on developing the hospital’s facilities in late 2019, and despite the challenges posed by the COVID-19 pandemic, the extension has been completed on schedule.
The expansion of St Peter’s continues to incorporate the bespoke design elements which make it dementia and ABI friendly.
The hospital has worked closely with The University of Stirling’s Dementia Services Development Centre, to create an environment that is not only innovative and therapeutic but also encourages patient proactivity.
Helen Rocker, hospital director at St Peter’s Hospital, says: “This is an exciting development for St Peter’s and we are looking forward to welcoming new patients to the hospital.
“With all of our staff and patients who are able to receive the vaccine having been vaccinated, this couldn’t be a better time to be opening the new facility.
“The last year has been very challenging and the staff have been exemplary throughout in their unswerving commitment to ensuring the highest standards of virus control. So it’s gratifying to be finally able to look forward and focus on new opportunities to develop our patient services.”
And with the increased provision for patients comes new job opportunities, says Helen.
“In order to support our additional patients, we will need to increase our staff numbers and we are actively recruiting for RMH and RGN Nurses as well as support workers,” she adds.
“We have just raised our nursing salaries by nearly 6.5 per cent and are confident that we currently offer some of the most rewarding career opportunities for nurses in South Wales.”
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