Shared learning database

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Published date:
November 2011

Poster submission. Large AO sized poster. Design is a pie design with each piece of the pie showing each stage of the project. Around the edge of the pie we have the areas of the project which match the QIPP agenda (Quality, Innovation, Prevention and Productivity).

Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

To have a standard approach across West Yorkshire Critical Care Network on the implementation of CG83 for critical care patients during their journey. To have a standard approach to the implementation of the CG83 and to include all 5 Acute Trusts and to be led by the Critical Care physios, facilitated by the West Yorkshire Critical Care Network

Reasons for implementing your project

The starting point was the publication of CG83. We discussed current practice against guideline recommendations, Identifying shortfalls and change required.

How did you implement the project

Initial Stage: Formed a West Yorkshire wide group of critical care physiotherapists and West Yorkshire Critical Care Network Service Improvement Lead. Reviewed the document, agreed a staged approach, Consulted with Critical Care Senior Nurses. Stage 1: Short and Medium Term goal setting. Standardised documentation; Education; Audit; (Senior nurses kept informed) Stage 2: Nurse rehabilitation champions identified, rehabilitation included in induction and education opportunities and a framework provided for on-going use. Stage 3: Patient leaflet developed including rehab goals. Designed and piloted the leaflet and approved by PALs in most areas. Stage 4: Exercise programme and diary developed, piloted and audited, amended and now in use across West Yorkshire. PCTs informed. Stage 5: Audit of use of short / medium term goals. Rehab included in Yorkshire & Humber wide Quality Key Indicators as a benchmark. Costs of meetings / printing design etc were covered by the WYCCN. Barriers: cultural change to thinking on critical care units. Working beyond critical care boundaries had to be achieved. Needed to encourage everyone to own the 'short and medium term goals' hence the identification of rehab champion. Psychology of patients was not addressed.

Key findings

At each stage documentation was piloted and amended. Patient exercise diary was trialed with patients and their comments taken on board. Profile of rehab is much higher in critical care areas. Critical care nurses and clinicians now have Rehabilitation goals each day and there is a more positive approach to rehab i.e. sitting patients out etc. Cost savings are no doubt occurring but very difficult to quantify. It could be that length of stays in critical care could be decreased. Identified that one unit lacked the required equipment to promote rehab and this had a small financial cost to that unit.

Key learning points

Ensure Key stakeholders with the appropriate knowledge are on board from the beginning and included at every stage. Rehab Champion is essential for raising and continuing the profile of rehabilitation. Raised profile of equipment required for rehabilitation. Poster developed to show at key Network meetings and Trusts to share achievements - again to raise profile.

Contact details

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Primary care
Is the example industry-sponsored in any way?