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Rehabilitation

Rocket science or Rehabilitation Stuart Fraser Therapy manager - Neurosciences University Hospital Southampton NHS Foundation Trust. Rehabilitation. ‘ To restore someone to health through training and therapy after illness’. What are the challenges. Health care costs Ageing population

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Rehabilitation

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  1. Rocket science or RehabilitationStuart FraserTherapy manager - NeurosciencesUniversity Hospital Southampton NHS Foundation Trust

  2. Rehabilitation • ‘ To restore someone to health through training and therapy after illness’

  3. What are the challenges • Health care costs • Ageing population • Growing population • Private sector • Lifestyle • Public expectations • Rising Acuity • Communication • No: of organisations

  4. What are the challenges Healthcare costs Ageing population Growing population Private sector Lifestyle Public expectations Rising Acuity Communication! No: of organisations!

  5. Early Mobilisation Project

  6. Why EMP? • Survival following critical illness is often associated with a poor functional outcome Herridge et al 2011 NEJM: 364;1293-304 • The combined effects of reduced sedation and physical activity are safe, well tolerated Schweickert et al 2009 Lancet: 373:1874-82 • Early mobilisation is defined as occuring within the first 2-5 days of admission, but barriers to this are often reported • Hodgson et al 2013 Crit Care: 17:207

  7. What did we ask for? • Small investment • Staff • Equipment

  8. How did we do it? Inclusion • Acute medical patients • <72 hours I&V • Expected to remain I&V >24hours • Functionally independent prior to admission (+/- aid) Intervention • Strict sedation protocol- minimal sedation at all times • 2x 30 minute additional therapy sessions per day

  9. Clinical outcome data for ICU survivors enrolled in the QI project (Pre-QI data is included for comparison) Data are expressed as mean (standard deviation), unless otherwise indicated.

  10. What did we do next?

  11. Neurological Intensive Care

  12. Achievements 2012-2016

  13. In summary • Its not rocket science! • Investment / savings • Safe • Promotes therapists as being leaders in Rehabilitation • It’s the right thing to do

  14. Thank you Stuart.Fraser@uhs.nhs.uk

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