PURPOSE: To improve the quality of physical function assessment through routine use of the Chelsea Critical Care Physical Assessment Tool (CPAx-D) in Danish ICUs. METHODS: The methodological framework was "The Model for Improvement," including the Plan-Do-Study-Act (PDSA) cycle. The context consisted of two ICUs at Aarhus University Hospital with 38 beds. Eligible patients were aged 18 years or older and considered stable and ready for physiotherapy treatment. Evaluation methods used were questionnaires, clinical practice observations, continuous feedback, status meetings, and an audit of the medical records including patients during a three-month period in the ICUs. RESULTS: The quality improvement process required three PDSA cycles and two years before CPAx-D was successfully implemented into clinical practice. The following barriers were identified
the COVID-19 pandemic increased workloads and caused reorganization of care
leave of absence of the project manager caused a lack of leadership
local instructions were not sufficiently aligned with practice
and detailed manuals were missing. A facilitator for implementation was the clinicians' perception of CPAx-D as a meaningful tool, adding value to interdisciplinary collaboration and communication, and stimulated patient motivation. CONCLUSION: By employing various interventions, routine use of CPAx-D has been successfully implemented into clinical practice at two Danish ICUs.