Coordinating rehabilitation in hospital after ICU discharge: Priorities and pitfalls

Abstract

After discharge from intensive care, patients frequently undergo multiple care transitions across diverse hospital-based specialities prior to discharge home. This comes at a time when physical, cognitive, and psychological disability is high, and patients are coming to terms with life-threatening illness and its consequences. Evidence for how best to organise and provide rehabilitation and support during this period are limited, and studies focusing on individual aspects, especially physical rehabilitation, do not support major effects on physical or quality-of-life outcomes. Key domains in which to provide quality care are physical therapy, nutrition, psychological/emotional support, and especially the provision of relevant information to patients and family members. Organisational structures that provide consistency and case management are valued by patients and families, and purely medical outcomes such as survival, quality of life, and measures of physical/psychological status may miss important differences in experience of the patient recovery process.