Improving postoperative functional outcomes through timely physiotherapy referrals in acute care surgery patients undergoing emergency abdominal surgeries: a multidisciplinary quality improvement initiative at Hazm Mebaireek General Hospital, Qatar.

Recovery in postoperative patients involves multiple domains including physical, physiological, psychological, social and economic aspects. Immediate postoperative physiotherapy (PT) is crucial for promoting early recovery and reducing hospital stay, particularly after common general surgeries like laparoscopic appendectomy, laparoscopic cholecystectomy and hernia repair. Despite its benefits, there is often a gap in the optimal delivery of PT services, as observed at Hazm Mebaireek General Hospital, where only 10.4% of postoperative patients were referred to PT. The project aimed to improve the Six-Minute Walk Test (6MWT) distance from 250 m to 350 m and the incentive spirometry inspiration volume (ISIV) from 927 mL/s to 1200 mL/s in acute care surgery (ACS) postoperative patients over a 12-week period. This was to be achieved by increasing the percentage of immediate postoperative PT referrals from 10% to 50% through multiple Plan-Do-Study-Act cycles. The project involved a multidisciplinary team of ACS surgeons, physiotherapists and inpatient nurses. The interventions included educational workshops, daily reminders and personalised reminders to on-call surgeons. Process, outcome and balancing measures were tracked to evaluate the effectiveness of the interventions. The percentage of immediate postoperative referrals to PT increased from 10% to 67.7%, surpassing the target. The average 6MWT distance improved from 247.17 m to 390.86 m, and the average ISIV increased from 927 mL/s to 1198 mL/s. There were no reported increases in fall incidents or pain following PT, indicating that the interventions improved care quality without compromising patient safety. The project successfully enhanced postoperative recovery through increased PT referrals, demonstrating the effectiveness of targeted educational interventions and systematic reminders. These findings suggest that simple, targeted interventions can significantly improve postoperative care. Future steps include institutionalising the successful strategies, expanding them to other departments and exploring broader applications to ensure sustainability and scalability.