Enhancing early functional independence following cardiac surgery: a quality improvement programme

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Quality Improvement Science

Background:

• Early mobility and activity programs are crucial for post-cardiac surgery recovery.
• Baseline data showed low functional independence (5.3% achieving ≥80% FIM score by POD 3) and limited walking distance (188m by POD 4).

Purpose of the Study:

• To implement a quality improvement project aiming for >80% of cardiac surgery patients to achieve a Functional Independence Measurement (FIM) score of 80% by the third postoperative day (POD).

Main Methods:

• A model-for-improvement framework was utilized for continuous enhancement.
• Data were collected pre- and post-intervention (February 2021 implementation).
• Statistical analyses included control charts, unpaired Student t-tests, and chi-squared tests.

Main Results:

• Patient functional independence significantly improved, with 91.4% achieving ≥80% FIM score by POD 3, sustained post-implementation.
• Mean FIM scores increased to 81.20±3.77 (p<0.001) by POD 3.
• Mean 6-minute walk distance improved to 267.90±36.10 m (p<0.001) by POD 4.
• Patient confidence in performing activities of daily living independently increased to 89.4% by POD 5 (p<0.001).

Conclusions:

• The quality improvement project successfully enhanced functional independence, walking distance, and patient confidence after cardiac surgery.
• The implemented early mobility program was safe, with no reported adverse events.