The BMJ Awards 2017: EducationBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1720 (Published 04 April 2017) Cite this as: BMJ 2017;357:j1720
- Nigel Hawkes, freelance journalist
- London, UK
Stroke multidisciplinary team educational programme
“There is no better example of the need for multidisciplinary teams than stroke care,” says Sunil Munshi, consultant physician at Nottingham University Hospitals NHS Trust. “We know that stroke units improve outcomes and a key part of that is the coordinated working of a team. But the multidisciplinary team strategy is not well implemented nationally, resulting in reduced quality of care.”
One failing, he says, is the neglect of continuing education for the team, though guidelines recommend this. “If you train the team you inspire them. It affects them in many different ways.” In 2010 Munshi and colleagues launched a stroke educational programme, a three day, four times a year course primarily aimed at hospital and community nurses and all therapists. “We thought we would teach around 15 nurses,” he says. “Now we do nurses, doctors, physios, nutritionists, occupational therapists—everybody. Some patients also attend.”
Over the past six years 450 nurses and therapists have attended the courses, which have been cited by Health Education England as an example that other fields should follow. In 2016, for the first time, the course was given to 194 medical students at Leicester, an initiative to be repeated this June.
Audits at Nottingham show improving performance on key stroke metrics, including mortality (down from 10.5% in 2012 to 7% in 2014-16), length of stay (21.1 days to 17), lower readmission rates (11.2% to 9.9%), and fewer falls. The education campaign cannot on its own be credited with all these improvements, as Munshi is quick to acknowledge, but it has played its part. The cost has been low because consultants have given their own time to develop and run the courses.
STEP-up to patient safety
When is “good …