Rehabilitation after critical illness (RaCI) enhanced physiotherapy input following critical care discharge: A quality improvement project

Abstract

Background Early rehabilitation within the critical care setting is proven to have significant impact on functional ability, however the optimum model of care following critical care is unknown. Generally, a decrease in intensity of therapy seen on wards is linked with an initial plateau in a patient’s functional ability. Objective The primary objective of this study was to determine whether enhanced rehabilitation after discharge from critical care reduces patients’ hospital length of stay within a tertiary university hospital. The secondary outcomes include the effect on patient’s functional ability, frequency of physiotherapy activity and the need for support on discharge. Methodology Forty-four critical care participants were involved, over a four-month period, to receive daily physiotherapy provided by the critical care physiotherapy team in addition to existing ward-based therapy. Data was compared to a matched sample (based on risk of developing physical morbidity) from the previous year. Results Compared to before the quality improvement project, clinically significant reductions in patients’ hospital length of stay following critical care discharge were observed with a median saving of 11 hospital bed days. Conclusion In this small, local project, this quality improvement work has demonstrated potential reductions in length of stay because of enhanced physiotherapy input following discharge from critical care.