Rehabilitation

Framework for assessing early rehabilitation needs following treatment in intensive care

The Post ICU Presentation Screen (PICUPS) is a simple 14-item clinical tool which supports triage and handover of patients stepping down from ICU into acute wards and on to rehabilitation. PICUPS Plus includes 10 additional items to identify potential higher-level items that may need to be addressed as the patient progresses during acute care.

Their purpose is to

  • inform the immediate plan for care on the acute ward
  • identify problems likely to require further assessment or evaluation by members of the multi-professional team and so trigger appropriate referrals

Together these help to inform development of a personalised Rehabilitation Prescription (RP) as the patient leaves the acute care setting. This sets out their needs for rehabilitation and helps to direct their on-going care after discharge from the acute ward. For most patients, this will be to home and community based services, but a small proportion may require a further period of inpatient rehabilitation before they are ready to leave hospital.

As well as guiding decision-making for individual patients, this information will help to identify where their needs are and are not being met. Used at population level, the information will enable us to quantify shortfalls in current service provision and to estimate the gap between capacity and demand for future planning. Developed in the context of the COVID-19 pandemic, the tools are also expected to be useful in future for any patient following prolonged treatment in intensive care.

Piloting

An extended national pilot programme started in December 2020. The aim is to encourage all ICUs in the UK to be using the PICUPS and RP routinely for all patients (COVID-19 and non-COVID) and to submit data to UKROC.

If you would like to become a pilot site, please contact: ICSRehabCollaborative@ics.ac.uk.

Dataset

The long-term aim is to establish the PICUPS and RP as part of the national data collection for patients who have ongoing needs for rehabilitation after leaving intensive care.

For further information please contact UKROC team: LNWH-tr.ukroc-rp@nhs.net

The Framework and related documents

Deep dives: Framework for assessing early rehabilitation needs following treatment in intensive care 

Here you can find supplementary resources developed by our expert writing groups specialising in dietetics, neurology, occupational therapy, physiotherapy, psychology and speech and language therapy.