Abstract
BACKGROUND
The National Institute for Health and Clinical Excellence (NICE) Clinical Guideline (CG) 83: Rehabilitation after Critical Illness was published to focus attention on a group of patients who can potentially endure a multitude of physical and non-physical complications following a serious illness. Historically the sequelae of critical illness have not been adequately assessed or managed despite growing knowledge in this area of health care.
AIM
To share the lessons learned during the ongoing implementation of NICE CG83 across five hospitals within one critical care network in a single county.
DESIGN
The critical care network director appointed a passionate and experienced champion to examine the current position within each hospital, make recommendations and provide expert knowledge and practical assistance to improve the rehabilitation of patients in accordance with the NICE guideline. The 'Quick wins' were successfully addressed to encourage the implementation process whilst allowing time for new services and processes to be developed.
RESULTS
Success was achieved by addressing the patient, relative and inter-professional communication issues as a network. All hospitals introduced discharge booklets and improved their discharge information and then chose different strategies to address the recommendations of the guideline in the most effective way possible. Strategies such as early intervention physiotherapy, the assessment and management of delirium, follow-up clinics and outpatient rehabilitation classes were among those implemented.
CONCLUSION
This paper outlines the processes developed, the difficulties encountered and showcases the valuable work that has been achieved.
RELEVANCE TO CLINICAL PRACTICE
Increasingly, hospitals have an obligation to comply with NICE guidelines for the benefit of patients. Rehabilitation following critical illness is important for patients to regain their former or best possible quality of life in a timely manner.
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