Notice from the National Health Commission on Improving the Early Rehabilitation Intervention Rate for Inpatients

       On February 28, 2023, the Medical Administration Department issued the "Notice of the General Office of the National Health Commission on Issuing the National Medical Quality and Safety Improvement Goals for 2023". It is mentioned that the rehabilitation medicine profession sets the goal of improvement as increasing the "early rehabilitation intervention rate of hospitalized patients". Early intervention is an important principle of rehabilitation treatment and also an important indicator of the quality of rehabilitation medical care.

      Of course, policies regarding early intervention in rehabilitation go far beyond that.

For example, in the relevant policies of the "Opinions on Accelerating the Development of Rehabilitation Medical Work" released on June 8, 2021, "early intervention in rehabilitation" is mentioned.

      Strengthen the training of all medical staff on basic knowledge of rehabilitation medicine, enhance their awareness of early intervention and the entire process of rehabilitation medicine, and integrate rehabilitation concepts into the entire process of disease prevention, diagnosis and treatment, and rehabilitation.

       Strengthen the construction of rehabilitation medical capabilities. With the core of enhancing rehabilitation medical service capabilities, we will focus on strengthening the rehabilitation medicine departments of tertiary comprehensive hospitals, tertiary traditional Chinese medicine hospitals, and tertiary rehabilitation hospitals' early intervention, multidisciplinary cooperation, and rehabilitation medical service capabilities for difficult and critically ill patients.

       Gradually promote the interdisciplinary cooperation model between rehabilitation and clinical practice. Putting patients at the center, strengthening early intervention in rehabilitation, promoting accelerated rehabilitation surgery, integrating rehabilitation throughout the entire process of disease diagnosis and treatment, improving medical effectiveness, and promoting rapid recovery and functional recovery of patients.

      On October 27, 2021, the National Health Commission issued a notice on the pilot work of rehabilitation medical services by the General Office of the National Health Commission.

Medical institutions actively carry out pilot projects for early intervention in rehabilitation medicine and accelerated rehabilitation surgery service models, innovate and promote close cooperation between rehabilitation medicine and clinical departments, integrate the concept of accelerated rehabilitation throughout the entire process of disease diagnosis and treatment, intervene in timely rehabilitation before and after surgery, and promote rapid recovery and functional recovery of patients. Gradually explore and develop good practices for early intervention in rehabilitation, and accelerate the pilot experience of rehabilitation surgery service models.

      On January 10, 2022, the Guangdong Provincial Health Commission released the "Implementation Plan for Accelerating the Development of Rehabilitation Medical Services", which advocates patient-centered approach, strengthening early intervention in rehabilitation, promoting accelerated rehabilitation surgery, integrating rehabilitation into the entire process of disease diagnosis and treatment, improving medical effectiveness, and promoting rapid recovery and functional recovery of patients.

What is early intervention in rehabilitation?

Firstly, early intervention is one of the important principles of rehabilitation. The so-called early rehabilitation intervention refers to starting rehabilitation intervention as long as the patient's condition permits, and the severity of the illness varies from person to person. The earlier the rehabilitation intervention, the better the patient's recovery. Early intervention in rehabilitation can not only effectively prevent complications caused by bed rest, but also improve patients' abnormal posture in standing and walking in the later stages. The purpose of rehabilitation is actually to maximize the recovery or improvement of patients' functions, so that they can return to their families and society.

What is the role and timing of early intervention in rehabilitation?

The role of early rehabilitation intervention:

1. Maximize functional recovery and reduce disability. 2. Prevention of secondary disabilities: DVT, secondary osteoporosis. 3. Prevent recurrence. 4. Shorten hospitalization days. 5. Reduce medical expenses and optimize the allocation of medical resources. 6. Improve the quality of life. 7. Reduce the burden on families and society.

The timing of early rehabilitation intervention:

We generally believe that rehabilitation training can be carried out when vital signs are stable and the condition no longer progresses, which is the best time for early rehabilitation intervention. After the patient enters the rehabilitation department, a rehabilitation therapist will give a rehabilitation assessment, comprehensively evaluate the patient's limb function, and develop a targeted rehabilitation treatment plan.

What are the main contents of early rehabilitation?

Early intervention is a critical period for functional recovery. Early rehabilitation methods should be selected based on the patient's condition. For example, for critically ill patients, preventive rehabilitation (such as placing good limbs, preventing pressure ulcers, lung infections, deep vein thrombosis, etc.), and supportive rehabilitation (such as using high-tech to carry out passive limb movements, muscle electrical stimulation, functional cycling, etc.).

The rehabilitation medicine team can intervene early in the intensive care unit to carry out bedside rehabilitation, and carry out rehabilitation treatment while clinical doctors treat patients. At this time, preventive rehabilitation and passive rehabilitation are the main means, laying a good foundation for further active rehabilitation of patients after their condition stabilizes.

4. What are the preventable complications of early intervention rehabilitation?

Coma induced awakening, respiratory rehabilitation, as well as complications such as pressure ulcers, deep vein thrombosis, joint contractures, and neurogenic bladder and intestinal tract infections.

Early intervention in rehabilitation greatly improves social benefits, reduces patient drug expenses, saves medical costs, and reduces hospitalization days. It not only shortens the patient's rehabilitation time, but also achieves better treatment results. It not only improves patient satisfaction, but also greatly helps the overall operation of the hospital. At present, more and more clinical departments of tertiary comprehensive hospitals have realized the important role of rehabilitation medicine, such as neurology, neurosurgery, ICU and other departments. Bedside rehabilitation treatment has also been carried out, and patients with stable conditions should be transferred to the rehabilitation department in a timely manner to continue recovering their functions.