Early Mobility

The Activity & Mobility Promotion program firmly establishes the concept that a systematic approach is beneficial in combating the harms of immobility in our hospitals. Throughout JHH, we have adopted structured quality improvement processes to promote a culture of activity and mobility. This site houses tools and training for the hospital-wide, adult ICU, and pediatric ICU activity and mobility promotion.

The Armstrong Institute for Patient Safety and Quality is leading a three-year national collaborative project that aims to prevent these short- and long-term harms, while reducing length of stay and readmissions. By improving care of patients on mechanical ventilation, we can save patients’ lives, prevent suffering and reduce health care costs.

Dale Needham, FCPA, MD, PhD, Director of the Outcomes After Critical Illness and Surgery (OACIS) Group at Johns Hopkins University School of Medicine, received an R-24 grant from the National Heart, Lung and Blood Institute (NHLBI). This R-24 project, entitled “Improving Long-Term Outcomes Research for Acute Respiratory Failure,” is aimed at creating resources for researchers conducting long-term follow-up of patients surviving acute respiratory failure and acute respiratory distress syndrome (ARF/ARDS).

Outcomes After Critical Illness and Surgery (OACIS) is a multidisciplinary clinical and research group focused on understanding and improving patient outcomes after critical illness and surgery. OACIS activities include clinical quality improvement projects and research focused on longitudinal, long-term patient outcomes assessments, both locally and nationally, with evaluation of physical, cognitive, and mental health outcomes.

PARK-PICU (Prevalence of Acute Rehab for Kids in the PICU) is a national point prevalence study to characterize the prevalence and characteristics of mobility as part of routine clinical care for critically ill children in United States PICUs.

This guide provides an overview of the importance of early mobility to the mechanically ventilated patient, explains how early mobility improves patient outcomes, and assists in developing a structure to implement early mobility. It also explains how to use the tools and slide sets to implement the concepts presented.

Early Mobilization Network offers an open forum for all professionals who are interested in the early mobilization and rehabilitation of mechanically ventilated intensive care patients throughout the whole critical care pathway, from passive to active rehabilitation within the ICU and post critical care rehabilitation.

Wes Ely, MD, MPH, Grant W. Liddle Professor of Medicine, and his colleagues at Vanderbilt and the VA have identified delirium as one of the most critical problems facing ICU patients — linked with increased deaths, prolonged ICU and hospital lengths of stay and significantly higher medical costs.

In January 2013, The Society of Critical Care Medicine (SCCM) published the Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit. This website is one of the tools offered to clinicians worldwide to achieve an aim of enhanced knowledge transfer of interventions to the bedside with special focus on the guidelines as well as assessment tools.

ICUsteps was established in 2005 and became a registered charity in 2006. Run by former intensive care patients and relatives, the aim is to improve the care and support available to patients recovering from critical illness during their long recovery.

Mobilization of Vulnerable Elders (MOVE) is an implementation and evaluation initiative to promote early mobilization practices in seniors admitted to hospitals.