Case management has faced unprecedented challenges during the past year, which has seen it respond with positivity and agility to ensure service to its clients could be maintained. In the latest in our Q&A series, Sarah Cooke from Bush & Co shares her experiences, and how the newly-adopted telerehab will undoubtedly play a role going forward.
Can you summarise how the past few months have been for you
It’s certainly been the biggest challenge of my career! But I feel proud of how we have all pulled together, in whichever capacity we work with our clients, so they have been able to continue their rehabilitation.
How did you adapt to the restrictions of lockdown? Were you able to do this quickly or did it take a bit of time?
I adapted pretty quickly to the lockdown restrictions as I already worked remotely from home so my office space was set up. It was also normal to communicate with colleagues and clients by email and telephone. The strangest part was going from a quiet house to having my family at home either working from home or furloughed. I’m sure this affected the internet connection at times!
I think working within a supportive team has been really important. By supporting each other we have looked after each other’s well-being which, in turn, has enabled us to continue delivering a first class service to our clients. It is important to remember we are clinicians but also have personal lives and have been affected like everyone else.
At the beginning of lockdown the Bush & Co management team reacted quickly to the situation and put a Covid-19 risk assessment in place, supported us with increased communications and the relevant, latest guidance. This enabled me to decide how to complete Immediate Needs Assessments and reviews and ensured good communication with clients and stakeholders was maintained. We also put new initiatives in place quickly such as loaning out tablets to clients who had little or no access to technology. This meant Immediate Needs Assessments could be completed remotely but also meant ongoing case management could continue.
What have been the main challenges – were you able to overcome them?
Initially the access to PPE caused a challenge. However for those clients that the Covid-19 risk assessment identified still needed home visits, Bush & Co were able to provide PPE packs for each visit. I think social media also helped at this time as I received additional face masks from LinkedIn connections who shared what they could spare.
At the beginning of the pandemic we were faced with how to keep our clients’ rehabilitation going. NHS departments had closed and important surgery cancelled. Plus service providers needed to convert to new ways of working. My main focus was preventing clients from deteriorating and enabling them to maintain during this period. This was where the stakeholders stepped in and ensured funds where available to support our clients. For example, one of my clients’ pain had increased so the stakeholders funded an electric profiling bed to keep her at home and comfortable whilst she waits for surgery. Another example is how the pandemic has hit a lot of our clients psychologically. The stakeholders have secured funding for telephone or virtual treatment sessions.
Has the use of ’telerehab’ been of benefit to you?
Yes absolutely! It has enabled our teams to keep in touch with each other in a more personal way. I must admit to preferring to be able to see people rather than telephone conferencing. It feels a little bit more like a face-to face meeting. I definitely think the use of online technology has proved to be a real asset during the pandemic. Professionally I have used Zoom, Microsoft Teams and Air Meet. These platforms have been great for attending meetings and staying connected with colleagues. I’ve also had access to lunchtime yoga and mindfulness training delivered by Bush & Co and webinars kindly hosted by law firms.
How have your clients responded? Was it difficult for them to adapt to?
Most of my clients have been open to communicating via telerehab. One of the issues we have encountered is that they are often using mobile phones or tablets and their devices have been unable to open the meeting links to Zoom. Generally, my client group have preferred to use the camera feature on social media apps, such as, WhatsApp or speak over the telephone.
If face-to-face contact has been identified as needed by the risk assessment and it’s been clinically safe and appropriate to meet in person, I have continued to visit clients so this has avoided causing any damage. I must say I have certainly missed seeing my colleagues in person but don’t think it has been damaging because we have used the virtual resources. Bush & Co has introduced ‘Happy Post’ so we’ve been connecting through good old fashioned letterbox mail as well as electronic ‘Postcards from Home’ which have been a way to see how other people’s lives have changed during the pandemic.
How central do you think the use of telerehab will be for you going forward?
I think telerehab will change our working practices and we will attend more virtual team meetings, multi-disciplinary team meetings, webinars and training sessions etc. Moving forward I will definitely consider telerehab for my clients but I don’t think it is a replacement for face-to-face client visits because of the nature of our work. I think a blended work approach is definitely the way forward.
How do you think the future of case management has been shaped by the pandemic?
I think there is a much better understanding of what home working is; the challenges, opportunities, limitations and rewards that it brings. Pre-pandemic I would use telephone or face to face client contact. The pandemic has made us aware of a third option – telerehab. It’s also opened up access to new providers of therapies and rehabilitation which would have normally been restricted due to distance from the client.
Will you be doing anything differently within your business going forward compared to pre-pandemic?
I have learnt during the pandemic the importance of physical contact with my clients. This is something I have probably taken for granted throughout my career. Some clients need this more than others, for example, because of lack of IT skills or cognitive impairment. There are clients though that engage really well using telerehab so moving forward I will definitely be embracing a blending working approach. Ultimately the clients’ needs have always been at the heart of the decisions we make and so going forward we’ll be taking our learnings forward in terms of telerehab needs too. Our clients are often vulnerable and may be anxious or reluctant to get back to ‘normal’ so we won’t be rushing.
