Mr King's Story - Main Story

This is one of a set of 5 films designed for interprofessional education.

• Main Story (this film): Mr King's hospital admission after a stroke
• Doctors and Nurses: Interviews with doctors and nurses who
work in the stroke team
• Therapists: Interviews with a Physiotherapist, an Occupational
Therapist and a Speech and Language Therapist who work in the stroke team
• Discharge and Social Care: Interviews with a social Worker and the other members of the stroke team who help the patient prepare for a safe discharge home
• Team Work: Perceptions from all the stroke team members about team working in the care of people who have a stroke

Background:
This story follows the care pathway of a gentleman just turned fifty who has a sudden unexpected stroke and is admitted to hospital. The patient consented for his experiences to be used for student learning and to ensure confidentiality we have changed his name to Mr King. The patient and family in this film are actors but the health care team members were practitioners working on the stroke unit at the time. We acknowledge the support of University Hospitals of Leicester NHS Trust.

This material was commissioned from the work of the Interprofessional Education Strategy, chaired by Dr Liz Anderson. It was funded by
De Montfort University Faculty of Health & Life Sciences,
University of Leicester Department of Medical & Social Care Education,
University of Northampton School of Health.
Directed and filmed by Cuckooland TV.

Teaching Materials
This film has been designed for interprofessional education. The learning content can be re-purposed in many different ways. In this guide we offer our insights for student learning. We use these learning materials to support placement learning when students are on clinical practice. The film can be viewed during reflective study time in study rooms adjacent to the clinical area. The adult learning approach requires small (n=2-5) interprofessional student groups and the film triggers debate and discussion.

The Main Story
The film begins with the ambulance crew preparing the patient for hospital admission. They phone ahead to the relevant hospital stroke admissions unit to report the planned arrival of Mr King. The patient is safely admitted to the stroke unit which in this Hospital is within an Emergency Medical Unit. Here the Stroke Consultant and his medical team confirm the diagnosis of probable stroke and then with the radiographer/radiologist assesses the type of stroke and then makes a relevant management plan. Following the initial assessment and early diagnostic tests Mr King is taken to the stroke ward. Here the day to day care of Mr King is managed by the nursing team who act as go betweens liaising with many of the specialist therapists, the medical team and the patient and family.
The film portrays the progression of the patient from early problems with swallowing as assessed by the Speech and Language Therapist, to treatment from the Physiotherapist and Occupational Therapist (OT). With time the patient makes improvement in functional tasks and options for ongoing care and discharge are discussed at the weekly interprofessional team meetings with the patient and family present. A home visit is arranged to look at facilitating firstly some home leave, and later a safe discharge. The Social Worker is portrayed supporting the family towards this, and the OT is seen preparing the home with adaptations. Discharge some 10weeks following the admission is to the local Primary Health Care Team and the community physiotherapy team who will all continue to monitor Mr King's progress.

Points for discussion
• What local arrangements are in place where locally to you?
In this story Mr King came in through a Rapid Ambulance
Protocol Team, where paramedics who find patients to be FAST positive alert the stroke team directly.
• Who constitutes your local stroke team? In this film there is a stroke physician and specialist stroke nurse.
• What imaging facilities are available locally? Why is access to these important? In the UK initial imaging would be Computerised Tomography. Further imaging using magnetic resonance imaging (MRI) might be indicated. How might the results of the imaging influence management?
• How might the efficiency of this initial assessment influence management?