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Nico Bolzan REHABILITATION

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Nico Bolzan, Physiotherapist, Clinica di Riabilitazione EOC (Ente Ospedaliero Cantonale), Faido

What sort of tasks do you personally use ANQ measurements for?

As a physiotherapist, I use the ANQ target documentation (ICF) in order to organise what I do. This is integrated into our hospital information system and can be accessed at any time. And I also conduct 6-minute walk tests. My work involves helping patients achieve specific defined targets. It was an excellent decision to introduce the ICF rehabilitation goals because they allow you to monitor just how effective each treatment is.

“ANQ measurements are our guiding light, especially for younger colleagues who have just finished their studies.”

How does ANQ influence your work?

Today, the importance of rehabilitation is constantly growing, while acute phases are steadily shrinking. The interdisciplinary model and measurement tools such as those used by ANQ are therefore also becoming more relevant. They allow us to provide patients with optimum support.

The measurement results show whether we are really giving them what they need. The target documentation based on the ANQ model provides us with a kind of guideline. If the condition of a patient changes, we can modify and/or refine any target that was defined at time of admission.

Can you give a specific example?

Sure - if someone has had to undergo hip or knee surgery and then comes to us, we would start by setting three or four main goals. These goals are standardised, one example being improvement of joint mobility. Then in a subsection of the form we can enter the patient’s personal goals.

“Rehabilitation is becoming more and more important as the average stay in acute care hospitals is becoming shorter and the population is getting older.”

What are the advantages of using the measurement results, particularly in physiotherapy?

They are an important support tool in therapy. And they bring about specific changes because they are reflected in what we do, be it in discharge management, the treatment plan or the patient’s participation. Today we focus much more on what a patient needs for their rehabilitation after being discharged. The FIM® scale is an excellent tool for monitoring a patient’s progress. I think it would be interesting if this scale was introduced into physiotherapy too.

Have the ANQ results already led to any improvements in your department?

Yes, several. We make the therapy schedule for the next day available on the evening before, because we have found that the patients need more information in advance in order to mentally prepare themselves. Furthermore, relatives know when they can come to visit.

A major benefit has been provided by the recent installation of automatic doors in the physiotherapy department. We decided to do this after studying the ANQ results and feedback from our internal patient survey.

What has changed in the hospital as a whole?

At hospital level, the ANQ results have had an impact on staff training.

In the case of hip prostheses patients for example, we’ve put together a training team to instruct the nursing staff on how to correctly set up a patient’s room, how to move a patient in bed and how to select the appropriate walking aid.

What other means could be used to measure the quality of physiotherapy?

You could make even better use of existing measurement tools like FIM® and CIRS by systematically implementing them in all hospital departments. Currently, physiotherapy is the only area where use of the ANQ target documentation (ICF) is mandatory. It is important to have a standard guideline for quality in all areas.

The ANQ instruments are important because they provide orientation and reproducibility. But it should be noted that taking more measurements also takes up more time, which means less time for treating patients. Another factor is that the expectations of a stay in rehabilitation are very different, which makes it difficult to identify new quality indicators.

“We need to develop a measuring tool that is able to register the highly diverse expectations of patients.”

Photos: © Geri Krischker / ANQ