A game changer in delivering therapy and supporting patients
All-in-One
All patient specific resources in one place
Sustainable
Saves paper and commute
Continued Care
From discharge to next settings
The Settings
Barking, Havering and Redbridge University Hospitals NHS Trust’s (BHRUT) stroke service is integrated within the Regional Neuroscience Centre, offering comprehensive inpatient and outpatient care for individuals who have experienced or are suspected of having a stroke. The service features a 14-bed Hyper Acute Stroke Unit (HASU) for immediate assessment and a 30-bed Acute Stroke Unit for ongoing care. Patients benefit from access to advanced equipment and collaboration with Neuroradiology and Neuro Vascular Surgery departments, ensuring prompt diagnosis and treatment. The multidisciplinary team includes seven consultants, specialist therapists, and nurses dedicated to delivering evidence-based treatments. Outpatient services encompass follow-up clinics and a one-stop clinic for transient ischaemic attacks (TIAs). Additionally, the service is committed to advancing stroke research in areas such as genetics, imaging, and carotid artery disease treatment.
The Challenge
The SLT team at BRHUT were looking to enhance therapy continuity and engagement for clinicians and patients, and to allow patients to continue therapy independently between or after sessions. They looked for ways to improve communication and cognitive outcomes, while reducing the burden on clinicians to source and manage resources. They recognised the need to bridge gaps in care, especially during transitions between services.
"Overall as a clinician my experience with Cognishine has been extremely positive and a game changer in delivering therapy and supporting patients to be more in control of their therapy. Cognishine are extremely helpful and will create new activities if requested by clinicians. As we are seeing a rise in younger strokes and people wanting to return to work/using emails/their smart phones, Cognishine is the perfect platform to practice that type of therapy on.”
The Solution
Patient Stories
Patient A
78 years old.
Left frontal stroke.
- Initially severe expressive and receptive aphasia – verbal output was 100% unintelligible characterised by jargon, reduced engagement in therapy activities- A had improved engagement with her family member, who requested activities that he could do with A outside of SLT sessions- SLT created a ‘board’ for A using Cognishine – the link was sent to her family member which meant he could access activities and continue to do them with A outside of SLT sessions- Therapy can then continue even after the service has come to an end- Email from family member stating that the activities were really useful and requesting more of them as they had gone through the current ones multiple times- By end of 6 week service, A was using total communication much more and communicating basic wants and needs, there was more intelligible words/phrases which supported functional communication
Patient B
61 years old.
Acute right paramedian hematoma.
Being seen as part of ESD - 6 week service at home following discharge.- Cognitive communication disorder characterised by perseveration of topic/idea, dominating conversation, reduced turn-taking, reduced awareness/insight into communication changes and new difficulties. Additional difficulties with attention and multi-tasking.- B was independently able to use mobile phone/ipad to access resources and actively engaged in therapy. B requested activities he could do outside of therapy sessions.- SLT created a ‘board’ for B with personalised activities that would work on above named deficits – e.g., one activity is ‘Point of view’ where the person looks at a picture that tells a story and has to describe how each of the people might be feeling/what they might say. B and his family member had increased tension between them due to B’s reduced awareness of his communication changes and difficulties identifying when his family member was busy and couldn’t talk. Following completing the activities with a family member and discussions with SLT in the next session, B stated that it was useful to think about how other people might be feeling. We were able to link that back to the ‘real world’ scenarios that he experiences. In the following sessions, B and his family reported an improvement in their communication and reduced tension.
Patient C
59 years old.
Right thalamic lacuna infarct.
- Cognitive communication disorder and receptive aphasia characterised by moderate-severe reading deficits, vague verbal output, and significantly reduced insight.- SLT primarily focused on attempting to raise insight as C had reduced engagement in therapy C engaged more with computer based tasks used with Cognishine and increased his insight. He stated following one exercise ‘yes that was hard, that’s a hard word, I found that hard’. Previously C had only stated that he found things ‘easy’ and it was ‘no problem’.- C was very active on his smart phone and computer and therefore computer based tasks were much more suited to him than paper based.
Results
The results of using Cognishine have been very positive, transforming therapy delivery and patient outcomes. Patients engaged more effectively in therapy, with personalised activities supporting their specific needs and enabling progress in communication, cognitive abilities, and functional independence. For instance, patients with severe aphasia or cognitive deficits demonstrated improved communication, insight, and reduced tensions in personal relationships.
Conclusion
Cognishine also empowered families to actively participate in therapy, enhancing its impact outside of sessions. Clinicians found the platform to be a time-saver, eliminating the need for extensive resource planning and printing while promoting sustainability. Overall, Cognishine improved therapy continuity, patient engagement, and clinician efficiency, making it a valuable tool in modern rehabilitation.
"Cognishine saves extra planning from the therapist in terms of finding resources on the drives and printing them out. It is better for the environment as we’re not printing paper. If a patient cannot access online then all the activities are available to print, but it is still an easy ‘go to’ platform where you can have all the patient specific resources in one place. When a patient is discharged from our service they can continue to access the activities via the link, meaning that they can continue independent therapy based activities prior to being picked up by the next team which can sometimes take months."
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