Nicola Graham Quality member’s showcase

Nicola tells us about the importance of investing in quality for her business, her team and her clients and how MSKPN is supporting its implementation.

“Quality for me means effective and evidence based treatment that is focused on the goals of the client.”

Bit about you and your business

My name is Nicola Graham and I am the Managing Director of tops:health. We have 4 sites in Oxfordshire delivering Physiotherapy and Sports Massage. We also offer Pilates and Yoga, private and group classes. tops:health was formerly The Oxford Physiotherapy Service, established in 1984, and Bicester Physiotherapy and Sports Injury Clinic joined the group in 2020. We are a team of nearly 30 professionals offering our expert services. I am a physiotherapist by background but have been non-clinical since 2017. I now focus solely on the business operations and management and am currently undertaking an MBA at Warwick Business School.

What does quality mean to you?

As a physiotherapist, for me quality means effective and evidence based treatment that is focused on the goals of the client. This belief has evolved to a broader term around “value based healthcare” that focuses on outcomes that we can deliver for clients. I am passionate about the service physiotherapists can deliver and the positive impact this can have on people’s lives and therefore I want to ensure this information is collected and is widely available.

What are the top benefits of quality data collection?

How did you commence the quality journey, what did you do?

As a high achieving physiotherapist, I have always valued data collection within my clinical practice and this has taken various forms over the years, but nothing has been standardised or automated, and therefore been consistently implemented. I historically and briefly engaged with a data collection tool advocated by another organisation but I struggled to consistently engage with this.

How has MSKPN helped this journey?

I joined MSKPN at the start of the pandemic and it was invaluable for general business support. I then volunteered to join the data quality sub-committee of MSKPN which was set up to follow on from previous work that had been undertaken with a variety of stakeholders around data collection in MSK services. The data quality sub-committee was led by Claire Small and Matthew Carr. However myself and other members provided feedback on data collection and possible implementation challenges within our businesses. MSKPN quickly engaged with practice management systems and aimed to automate data collection in a standardised format.

 What problems did you encounter/lessons learnt?

Some of the larger organisations in MSKPN were able to engage with a slightly more expensive data collection software company called Cemplicity straight away. Whilst this relationship was developing, I decided to be a ‘guinea pig client’ for FollowApp Care, who were investigating whether their software, specifically used by dentists, could be transferred to the MSK space. This patient engagement software has provided us with daily feedback regarding both quantitative NPS surveys and qualitative experiential data. We have also started collecting clinical outcomes through it around pain, function and goals.

FollowApp has been a great and simple introduction to regular data collection within our team and we look forward to transferring to the more robust and granular data collection system that Cemplicity offers. We have faced the expected challenges around team engagement from a time perspective, rather than objecting to it as a process, hence why we are automating data collection through technology software which also provides more objective outcomes.

Why is quality important to you, your practice, your clients?

Understanding quality is important as we live in a data driven world. When clients don’t complete a course of treatment or rebook follow up sessions, we can contact them but if they don’t respond, we can’t complete our clinical reasoning as a therapist, and even more concerning, is that we assume that they have got better and are fine. This is detrimental for an individual therapist’s professional development but also for the reputation of physiotherapy and the value we can offer and provide within our clinical care.

We need this ongoing communication with clients that technology can provide, as well as the objective ability to assess how someone is progressing and we intervene and engage with them at appropriate times to ensure rehabilitation programmes are completed. We want to offer excellent care and for every client to have a positive experience. If we don’t collect data, measure these outcomes then we have no baseline markers to develop from. We then need to ensure we advocate our value, continually review our systems and processes and continue to innovate to drive the profession forward.

What advice would you give to others?

Start collecting data now! Set time aside and work out a process that will work for your business. Implement it, review it and let it naturally evolve. Learn to challenge your assumptions, feel comfortable with hearing both the positives and negatives of your business and engage with your team to create space for conversations around how development can occur. Engage with technology and software options, if possible, to automate the processes and understand how they can assist you. Reach out to colleagues, peers and MSKPN to discuss your options.

At the end of the day, if we aren’t measuring it, then we can’t improve it and that will become a massive barrier to the profession’s development and sustainability.

Learn more

Click here to download:  Nicola Graham quality showcase