Improving patient care, outcomes and experience we have become the first UK centre to publish results with this treatment (British Medical Journal Case Reports 2015, doi:10.1136/bcr-2015-209716).
Our demonstrated outcomes include control of daytime ventilatory failure by mouthpiece ventilation (MPV), which was not possible with standard mask treatment; survival is prolonged by treating the potentially life-threatening respiratory acidosis.
The patient experience has also been radically improved; individuals who were otherwise unable to leave the house, and were dependent on the help of others to use their ventilator, have been able to resume activities of their choice.
Improving efficiency, productivity and value for money Complex ventilation is provided by the regional service here at Aintree, and as part of this the physiotherapy ventilation team have led the introduction of MPV. When the need for daytime ventilation is identified, physiotherapy-led trial of MPV takes place during outpatient contact. Initiation of a new ventilation mode within a single outpatient appointment represents exceptional value for money for both the Trust and the regional healthcare economy; the physiotherapy ventilation team chose to offer the treatment on this basis to avoid increasing elective admissions to the ventilation unit. Twelve individuals have received MPV so far by this method.
Improving team working To make this model sustainable, changes have been made within the physiotherapy ventilation team. Through restructuring of duties and improved team working, regular outpatient appointments have been made available in the physiotherapy ventilation team whilst inpatient unit cover is also maintained. We have also implemented a system of risk assessment undertaken by our therapist assistant practitioner, to assist in identifying patients who require trial of MPV.
Conclusions Mouthpiece ventilation may offer both practical advantages over daytime mask ventilation, and improve the patient experience while prolonging life; we have shown that this simple change to the ventilator configuration can be delivered in a single outpatient visit led by allied health professionals.
We were very pleased to receive a Proud of Aintree Award for this work, and it has been an honour to share this project with the Academy of Fabulous NHS Stuff - we hope that other ventilation providers may consider this option for their patients in the future.
For further information please contact Karen Ward, Consultant Physiotherapist [email protected]