Administrator Perspective: Leading Change in Your ICU
ICU early mobility interventions may make a big difference in patient recovery. Research shows they may contribute to increased hospital survival rates1* and better functional outcomes.2 And the benefits don’t stop with patients. Early mobility programs may lead to shorter patient hospital stays,2 lower readmission rates,3 and result in an overall cost savings for the ICU4 — potentially freeing up ICU resources.
With a bird’s-eye view and various staff touchpoints, administrators play a unique and vital role in getting such a program off the ground. You orchestrate the interaction of diverse stakeholders, influence decision-makers, and encourage clinicians. You also provide support, resources, and access to training.
Let’s look at ways you can use these tools to make early mobility a reality — and a success.
ICU Early Mobility: Supporting Different Stakeholders
Acting as the boots on the ground, clinicians face many constraints when implementing and maintaining an early mobility program. For example, they may be short on time, knowledge, or staff. Or they may be working in a culture of immobility. You can help them remove some of these barriers through proper planning, investment, and encouragement.
Let Equipment Ease the Burden
Make sure technology isn’t limiting patient progress or hindering staff efforts. A variety of technological advancements are available for support:
- Consider investing in ventilators that allow patients to breathe easier.
- Explore technology that caters to even very active mobilization.
- Read up on reliable tracking, which may help clinicians evaluate patient progress and assess readiness for advancement.
Additional staff can bring expertise and extra hands to help mobilization events go smoothly. Common new hires include a coordinator, a rehabilitation technician, a physical or occupational therapist, or a physician leader.4 Explore personalized new hire cost estimates and recommendations. For those unable to invest in new hires, additional staff aren’t necessarily a precursor to early mobility. Proper planning may ease or eliminate this need.5 Learn how.
Invest in Clinicians
Well-prepared staff members contribute greatly to both the safety and the success of early mobility programs. Ensure your team is ready for the task.
- Bring in speakers on related topics, provide training sessions, and send staff to workshops or conferences.
- Support clinicians with the latest research and best practices (for example, how to assess patients or how to help patients progress).
- Encourage clinicians to create a mobilization protocol that works with your ICU’s resources and needs.
Administrators and other decision-makers have a variety of responsibilities and concerns. They must balance potential investments with budgets, new patient programs with staff workload. Support them by showing that, with early mobility, there are few tradeoffs.
Stress the Stakes
Some decision-makers might not be aware of the extent of the effects caused by immobility. For example, a lack of ICU mobility participation is among the variables that predict readmission and death.3
- Provide statistics on the side effects of immobility.
- Show how patients benefit from an early mobility program.
- Share personal success stories through guest speakers or video case studies.
Reveal the Economic Potential
Early mobility expenditures are not just costs, they are investments. Show other decision-makers how establishing such programs can be a boon to ICU resources. For example, even when adding additional staff, cost-benefit calculations suggest that these programs may ultimately save on costs.4*
- Calculate the cost savings for your individual ICU with the Early Mobility Calculator.
- Show how other ICUs have implemented early mobility and saved.
Dispel Safety Misconceptions
Safety may be one of top concerns for administrators and clinicians alike. However, research shows adverse incidents during early mobility are rare.2 These incidences are seldom serious and don’t usually lead to additional treatment or longer length of stay.2
- Share the research on ICU early mobility safety.
- Explore the common misconceptions about early mobility, including those about safety.
Last, don’t forget that early mobility is a team effort. Recruit a multidisciplinary advocacy group to educate your team on the communication techniques and support technologies that can help an early mobility program thrive.
Explore how Medtronic is helping clinicians and patients RISE with the early mobility initiative.
1. *As a part of ABCDEF bundle compliance. Barnes-Daly MA, Phillips G, Ely EW. Improving hospital survival and reducing brain dysfunction at seven California community hospitals: implementing PAD guidelines via the ABCDEF bundle in 6,064 patients. Crit Care Med. 2017;45(2):171–178. doi:10.1097/CCM.0000000000002149.
2. Cameron S, Ball I, Cepinskas G, et al. Early mobilization in the critical care unit: a review of adult and pediatric literature. J Crit Care. 2015;30(4):664–672. doi:10.1016/j.jcrc.2015.03.032
3. Morris PE, Griffin L, Berry M, Thompson C, Hite RD, Winkelman C, et al. Receiving early mobility during an intensive care unit admission is a predictor of improved outcomes in acute respiratory failure. Am J Med Sci. 2011;341(5):373–377.
4. Lord RK, Mayhew CR, Korupolu R, et al. ICU early physical rehabilitation programs: financial modeling of cost savings. Crit Care Med. 2013;41(3):717–724. doi:10.1097/CCM.0b013e3182711de2
5. Dubb R, Nydahl P, Hermes C, et al. Barriers and strategies for early mobilization of patients in intensive care units. Ann Am Thorac Soc. 2016;13(5):724–730. doi:10.1513/AnnalsATS.201509-586CME
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