The Impact of Introducing Generic Therapy Assistants to an Acute Occupational Therapy Stroke Service

Background It has been recommended that patients post-Stroke should receive 45 minutes of Occupational Therapy (OT) input on at least five days per week to evoke meaningful and significant improvements in patient-centred outcomes. However, service capacity cannot always meet recommended levels. Generic Therapy Assistants (GTAs) offer opportunities to bolster staffing and increase intensity and quality of OT input. This pilot aims to investigate the impact of the recruitment of two GTAs upon OT services in an acute Stroke unit. Methods Two GTAs were recruited to the service and underwent tailored training, followed by in-service training and supervision support. Data was collected prior to their recruitment for a four-week period (Timepoint 1) and again following their appointment (Timepoint 2). Duration of OT sessions were categorised as High (>36 minutes), Moderate (23-36 minutes) and Low Intensity (<23 Minutes). Key metrics were the number of sessions that took place, the proportion of sessions deemed low, moderate and high intensity and a functional measure of included patients using the Functional Independence Measure (FIM). Results Total sessions increased from 113 to 184 from Timepoint 1 to 2, and sessions deprioritized reduced from 116 to 71, with greater contact time per day during Timepoint 2. The proportion of sessions described as High Intensity increased from 45% to 63%. Twelve patients from each cohort had functional changes measured, with scores recorded on initial assessment and on discharge. Average increases of 3.75 points were observed during Timepoint 1, and 8 points at Timepoint 2. Conclusion The addition of two GTAs to the Stroke service in this acute hospital facilitated positive changes to the OT service capacity and delivery. Increased numbers of sessions and session duration were observed, alongside a greater proportion of sessions being of High Intensity, and greater functional improvements when compared to similar data collection prior to their recruitment.