Used to calculate PA undertaken by the patient at the initial assessment.
The PA calculator allows us to ascertain the normal activity levels of our patients, and to compare this to the CMO guidelines. This gives us an understanding of how to advise them on being active at home. It also gives us a baseline with which to compare function on the ward. The assessment is completed by nursing staff and HCAs with new patients when they arrive on the ward. Brief advice based on the CMO guidance is linked via a “help button” so that staff can give information about physical activity to patients.

At the beginning of the project, the Patient and public involvement group (PPG) had produced a sheet, with one side presenting the benefits of exercise. This was developed during the project in conjunction with the PPG, physiotherapists, and ward staff. It now has information on the benefits of physical activity on one side, and chair and bed exercises on the other side. The exercises have QR code links to physiotherapy resource videos demonstrating them.

6 HCAs received training on the exercises on the “Keep Moving” sheet.

Ward staff and volunteers support patients to complete the exercises.

The digital assessment has conversation starters, and advice, which can be used to discuss physical activity with patients during the physical activity assessment.

ASK the patient:  Can I talk to you about something that may be important for your health – how to safely move more?

Suggestions on how to start a physical activity conversation:

• Why might you want to become more active?
• What do you see as the 2-3 biggest benefits to you personally of becoming more active?
• What do you think you might notice, if you became and stayed more active?
• If you decided to become more active – and that is entirely up to you of course – how would you get started?
• What kind of activities or exercise did you used to enjoy, in the past?

ADVISE the patient: Give appropriate advice to your patient, for example to move more in bed, get out of bed to sit in their chair, move around their bed space, walk to the toilet, walk further: provide supervision and walking aids as needed.

We trained a mix of 12 nursing staff, prehab exercise professionals, and therapists to be able to deliver the Physical Activity Champions training within the Trust. These staff will be able to ensure that new staff to the ward will continue to have been trained as Physical Activity Champions.

This role is an essential part of the roll out of the project, as it will allow us to develop the network of staff trained as “Physical Activity Champions”. It includes a smaller core team of 4 staff meet regularly to arrange and deliver this training across the Trust.

As part of our first PDSA cycle we recognised the pressures on Nursing and HCA time as a barrier to delivering the “Keep Moving” exercises regularly. Volunteers were identified as a potential solution to this issue. A Volunteer role was developed and is being piloted. Volunteers receive training from a video, and then from a face to face session with the project lead.

Volunteers are reporting that they are receiving positive feedback about their physical activity sessions. We will be gathering feedback from patients in March 2023 to start an evaluation of the role.

Recruitment of volunteers can take a long time. It is important that the volunteers have someone to talk to about their successes and challenges, and that they have regular support in this new role, which can be time consuming for the project team. It is hoped that as they embed on the ward, the ward staff can increasingly provide this support.

The volunteers themselves are reporting that they enjoy the sessions. We are planning some feedback sessions later in the spring to help us to shape the role moving forwards.

The UK CMO Physical Activity Guidelines for Adults were displayed on patient noticeboards to raise awareness and knowledge around the recommendations for PA

The Arts trails are being curated in partnership with the Arts co-ordinator at the Trust. The trails will link together current and new arts displays, and include dance choreography being produced for this project. They aim to promote movement, by encouraging people to walk them, and by showing that dance is accessible to all.

Online and Physical maps encouraging walking within the hospital being developed as part of an “Arts Trail”, a joint project with the Trusts Arts co-ordinator, and kindly funded by Art Council England and NUH charities..

Health and Safety, Fire, and Infection Control advice and agreement is required to make plans to rehang art works from storage, and to agree to put up new plaques with information about the art works, and links to creative writing and films of dance routines relating to the art works. A working group with representatives from each group was set up to discuss this, and to support the project as it moves through our space management processes.

Risk assessment relating to hanging the art works is currently progressing through governance structures.

Risk assessment relating to staff dance sessions involving a dance choreographer, which we plan to film and link to QR codes on the trails, is being developed currently.

Risk assessment relating to a potential volunteer role, to show people walking through the hospital the trail and art works, is currently under discussion.

Graphics

Material was produced to support the internal/external promotion of the Active Hospitals work.

The communications tream have supported the project internally through screen savers, brief videos explaining the project, and Trust Briefings.

An Active Wards Toolkit is being developed for roll out to other wards, with basic introductory information about getting involved in the project, with key actions and contacts.

Risk Assessment and Standard Operating Procedures for ward staff and volunteer engagement was taken through specialty governance structures.

A risk assessment was developed by the project lead, and agreed with ward manager and consultant via a working party group. A standard operating procedure was developed in conjunction with this. These documents were taken to specialty and divisional governance groups, where the project lead and ward manager presented the plans and risks.

This process was necessary in terms of governance, but also useful in terms of raising the profile of the project. It added considerably the timescales for the ward starting the project, as the different governance groups ran a month apart. It enabled positive feedback on the project, and garnered support on both a specialty and a divisional level. It allowed us to create a framework for roll out on other wards. The risk document needs adaptation to different clinical areas, but creates a framework with which to do this. So far it has been used successfully to agree risks with a renal ward, and it will be presented on health care of older people wards in the future.

The Active Hospitals programme reports internally to the Health Improvement Steering Group, which has system wide representation.

Information board including:

UK CMO infographics

Keep Moving Sheet.

Online and Physical maps encouraging walking within the hospital being developed as part of an “Arts Trail”, a joint project with the Trusts Arts co-ordinator, and kindly funded by Art Council England and NUH charities…