Early Rehabilitation in Critical Care the Focus of Pilot Project

January 10, 2019

​By :Greg Winson

For patients admitted to the Intensive Care Unit, early mobility can be a key factor to a successful recovery. Now a pilot project underway at St. Michael's Hospital and St. Joseph's Health Centre will further study the impact of movement on recovery and provide a standardized toolkit of best practices to critical care units across the province.

The Provincial Early Recovery in Critical Care (PERCC) initiative is sponsored by Critical Care Services Ontario.

 "Maintaining strength is very important," said Dr. Andrew Baker, medical director of the Critical Care program at St. Michael's. "It allows you to maintain activities of daily living, everything from getting out of a chair, sitting on a toilet, to brushing your teeth and feeding yourself."

Maintaining strength has the potential to reduce the length of stay in hospital, and reduce or eliminate the need to go to a rehabilitation hospital as part of recovery.

Early mobility represents a shift from the traditional concept of a patient resting and recovering before undergoing any sort of rehabilitation.

"It doesn't always seem intuitive, because you think, if someone's really sick they need to rest," said Deanna Feltracco, a physiotherapist in the Medical Surgical Intensive Care Unit at St. Michael's. "But it's actually good for patients to get up and mobilize."

Each patient receives a chart with a number based on what they achieved in their mobility session, ranging from passive bed exercises to walking independently. The chart, posted at the bedside, shows patients their progress.

 The early rehabilitation concepts learned during the pilot will eventually be rolled out to Critical Care units throughout Ontario.

"The primary objective is to help patients," said Dr. Baker. "The goal is to get patients better sooner."

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