Early ICU Standardized Rehabilitation Therapy for the Critically Injured Burn Patient

This 2nd Phase of the Study will develop a deeper understanding of clinical factors surrounding the “repetitive and re-look” procedures within the Critically Ill Burn Patient Population. This UHC database review study will increase the medical literature’s understanding of what contributes to variability in practice surrounding the care of burn patients with conditions necessitating multiple planned operations. This insight will be essential to the future design and execution of a revised Burn ICU Rehabilitation study (a future grant application). The optimal future design will more effectively coordinate interventions among and across critical care, surgical, nursing, physical therapy, respiratory therapy and related disciplines. Our overarching hypothesis of the 2nd Phase of this grant award is that variation in practice among patients requiring planned repetitive operative therapy negatively impacts resource utilization and treatment of critically ill burn patients. Efforts to standardize these aspects of care have potential to more effectively target rehabilitative interventions in the setting of burn patients. The new phase of this grant will examine medical records within a large national hospital database (University Hospital Consortium’s database). A barrier to the rehabilitation efforts within the original study’s intervention arm was the immobilization of the critically ill patient, whether due to the injury or as a side effect of supportive care. Minimizing the duration of this immobilization and developing strategies to lessen its impact are the goals of this proposed continuation plan. To the extent that periods of immobility are due partly as a consequence of variability in operative practice, understanding and minimizing such variability has the potential to translate into more timely recovery of the severely injured patient, including those sustaining burns