A new service for children about to have orthopaedic operations at Basildon University Hospital is helping to reassure them and their parents, and to reduce their length of stay.
The pre-op therapies assessment clinic was the idea of Elly Martin, senior paediatric therapy assistant, who noticed that children who were seen by therapists before their operations responded better to therapy afterwards, because the physiotherapists and occupational therapists were familiar to them.
Elly said: “I also thought we could get them back home quicker if we assessed what equipment they would need after their operation, and arrange for them to have it straight away.
“If needed, we can visit children at home, to see where the steps and stairs are and where the toilet is. This helps us identify what non-weight bearing patients might need, for example, a temporary commode. We can also get them practising moving round their home on crutches or a frame.”
If the patient attends school or college the therapists will gather information such as - can the young person stay on one level, is there a toilet near their class, would they need a helper to carry their bags?
Elly checks to see when young patients are coming for their pre-op assessments in children’s outpatients and ensures that the therapists attend too.
The service was launched last May and has reduced length of stay for many patients because their discharge is not delayed by waits for essential equipment. Ordering equipment in advance is also making a financial saving.
One young patient who has benefited from the new service is Grace Willbourne. Grace, aged 7, from Brentwood, had surgery for femoral anteversion – inward twisting of the thigh bone.
Her mum, Catherine Spearing, explained: “When Grace was three I noticed she was walking with her toes turned in. She is autistic and hypermobility can be associated with autism. We were referred to Mr Sean Symons, orthopaedic surgeon, at Basildon Hospital – he said because her bones were still forming it was too early to say what treatment might be needed, and that he would watch and wait.”
Last year, Grace was diagnosed with femoral anteversion, and Mr Symons recommended an operation, which would involve breaking her bones and straightening them.
Catherine said: “I was very shocked but I did not want to show my emotions because I knew it would upset her. After we were given a day, I had a call from Elly, saying ‘we are here to help.’ She told me to call her if I had any concerns - I had so many questions and you don’t always think what to ask at your appointments.”
Elly said: “I explained my role and how we would support Grace. We arranged for the learning disabilities nurse to attend the pre-op assessment and we visited the family at home. We knew Grace would be able to weight bear but because of her conditions it was best to act as if she could not, because any pain would distress her. She needed a ‘banana board’ to transfer her from bed to wheelchair – Catherine had bought a camp bed for downstairs but it was too low so she slept on the sofa. Access in and out of the house had steps, so we got Catherine to practise using the wheelchair safely.”
The operation went well; Grace comes to hospital once a week for rehab and is making very good progress walking on a frame.
Catherine said: “I have told Elly she has been a real godsend. Because everyone was introduced to Grace and she saw people in her home it has been a lot less upsetting for her – she usually dislikes any change or being touched but she has been fine with it. The care has been fantastic.”