1. Mary Duguid Occupational Therapist Aberdeen Royal Infirmary

2.  To examine whether iPads can improve the efficiency and communication associated with the discharge of amputees from an acute hospital to their home or community settings.

3.  All new amputees have an environmental home assessment  Information fedback to patient  Actions agreed  Adaptations/equipment or rehousing proceed Occupational Therapy in TeleRehabilitation - OTTeR

4.  Amputees transferred to care of community therapist  Handover via email or telephone Transfer techniques Prosthetic components/information Early walking aid Physiotherapy and Occupational Therapy in TeleRehabilitation - POTTeR

5.  November 2014 – February 2015  iPad with cisco jabber application  “live” link up with patient in hospital and therapist in patients home  “live” multidisciplinary handover with patient to community hospital therapists

6.  Staff and patient experience surveys  Data gathering regarding patient progress on amputee pathway

7. Live link up for: Three environmental home assessments Two handovers to community therapists

8. Occupational Therapy in TeleRehabilitation - OTTeR

9.  Day 9 post amputation  VC environmental home assessment  Equipment needs identified  Equipment ordered  Day 10  Rails delivered  Day 16  Equipment in situ and rails fitted  Day 18  Discharged home Occupational Therapy in TeleRehabilitation - OTTeR

10.  Instant decision making – saved an estimated 3 days which equals £2,319.  Improved patient health score.  Discharged home day 18. Occupational Therapy in TeleRehabilitation - OTTeR

11.  “It was brilliant it made me feel that my input to the experience was important”  “It made me feel very positive”  “It made me aware of the practicalities required for my release from hospital”  “I was very happy we were able to do things this way” Occupational Therapy in TeleRehabilitation - OTTeR

12.  Contact with Mr B  Discuss Mr B’s needs  Immediate consent  Hospital OT directly involved  No additional visit Occupational Therapy in TeleRehabilitation - OTTeR

13.  “Illustrated exactly what therapists talking about” MR C  “Encouraged me, I want to go home, motivates me to practice my transfers here in hospital” MR C  “Made me realise what changes required (wouldn’t have thought about some changes required” MR E Occupational Therapy in TeleRehabilitation - OTTeR

14. Physiotherapy and Occupational Therapy in TeleRehabilitation - POTTeR

15.  “Done a lot to prepare me” MR D  “Beneficial to meet therapists” MR A Physiotherapy and Occupational Therapy in TeleRehabilitation - POTTeR

16.  “Patient centred as patient able to meet therapist before transfer” COMMUNITY THERAPIST MR D  “Visually see transfer not just have it described” COMMUNITY THERAPIST MR D  “Aware of current abilities and goals” COMMUNITY THERAPIST MR A  “More prepared for seeing patients” COMMUNITY THERAPIST MR A Physiotherapy and Occupational Therapy in TeleRehabilitation - POTTeR

17.  “Made transition of care more effective” COMMUNITY THERAPIST MR D  “Environment set up prior to transfer to community hospital” COMMUNITY THERAPIST MR D  “Ensure others aware of patient transfer technique” COMMUNITY THERAPIST MR D Physiotherapy and Occupational Therapy in TeleRehabilitation - POTTeR

18.  Positive feedback  Motivational  Goal planning  Improved communication  Early evidence of time efficient practice  Timing of transfer to community hospital  Wifi access

19.  Using iPads to link staff and patients to prepare for discharge is both acceptable and efficient.  Minimal disruption to patients in hospital.  Potential to minimise length of stay.  Clearer exchange of specialist knowledge to community based staff.

20.  corroborate early efficiency savings indicated from initial results  enhance the rehabilitation process, patient experience and outcome  provide specialist education and support to staff in community settings

21. EuroQol Research Foundation [internet]. 2015 [cited 2015 March 23]. Available from: http://www.euroqol.org/home.html. http://www.euroqol.org/home.html Scott H, Patel R, Hebenton J. A survey of the lower limb amputee population in Scotland 2012. Full report. Glasgow: SPARG Scottish Physiotherapy Amputee Research Group; 2015.

22. maryeliza.duguid@nhs.net