NICE CG83 - rehabilitation after critical illness: implementation across a network

Area of Science:

• Critical care medicine
• Rehabilitation medicine
• Health services research

Background:

• Critical illness can lead to significant physical and non-physical complications.
• Historically, the sequelae of critical illness have been inadequately assessed and managed.
• The National Institute for Health and Clinical Excellence (NICE) Clinical Guideline (CG) 83 provides guidance on rehabilitation after critical illness.

Purpose of the Study:

• To document the implementation process of NICE CG83 across five hospitals within a critical care network.
• To share lessons learned and challenges encountered during guideline implementation.
• To highlight successful strategies for improving patient rehabilitation post-critical illness.

Main Methods:

• A dedicated champion was appointed to oversee implementation, assess current practices, and provide expert support.
• Focus was placed on addressing 'quick wins' to build momentum for change.
• Network-wide collaboration was established to tackle communication issues among patients, relatives, and inter-professional teams.

Main Results:

• All participating hospitals implemented discharge booklets and enhanced discharge information.
• Various strategies were adopted, including early intervention physiotherapy, delirium assessment and management, and follow-up clinics.
• Network-wide improvements in patient, relative, and inter-professional communication were achieved.

Conclusions:

• The implementation of NICE CG83 demonstrated successful strategies for enhancing critical illness rehabilitation.
• Addressing communication and implementing targeted interventions are key to improving patient outcomes.
• Hospitals have an obligation to comply with NICE guidelines to ensure optimal patient recovery and quality of life.