iMprOving Multi-disciplinary rEhabilitatioN Transitions from the intensive care Unit in Medical and surgical patients (MOMENTUM): A therapist-led intervention development study
The intensive care unit (ICU) delivers high-intensity specialist care to critically ill patients. There is strong UK-based evidence to suggest that during patients' transition from ICU to other wards, quality of care is often diminished, resulting in poor health outcomes. A recent quality improvement programme in Cardiff and Vale University Health Board demonstrated significant potential improvements in care, reducing hospital length of stay through enhanced care during patient transition from ICU. This project will explore the transitional period of ICU patients to other wards, to enhance understanding of the patient journey and develop a multi-disciplinary, evidence-based, person-centred intervention to improve outcomes for these patients.
CEDAR lead this project, undertaking data collection, analysis and interpretation, and reporting. A co-design for healthcare intervention approach was taken to identify and develop an intervention that could be tested in routine care in a future research project. CEDAR ran interviews and workshops with therapies staff (Physiotherapists, speech and language therapist, occupational therapist, Dieticians and Phycologists) from ICU and ward-based area, and patient or family members with lived experience of ICU.
Together staff and patient representatives proposed with eight improvement initiatives these included general orientation cards, co-produced training material using patient stories, information leaflets and sign posting given on discharge, a rehabilitation prescription summary, electronic handover, a rehabilitation co-ordinator, step-down multidisciplinary team meetings and rehabilitation diaries. Future work is planned to formally and robustly evaluate these improvement initiatives through quality improvement cycles, including the longer-term health, quality of life outcomes and assessment of cost effectiveness.