Early Mobility Program Gets ICU Patients up and around Sooner, Helps Speed Recovery

By: Franciscan Health Last Updated: May 12, 2014

Barbara-Goletz-FranciscanBrooke Nack, a physical therapist with the Rehabilitation Institute of Chicago at Franciscan St. Anthony-Crown Point, wears a white button that has a red anti-sign through the words, Bed Rest.

The reference celebrates a recently implemented Intensive Care Unit Early Mobility program that has been instituted in Franciscan Alliance’s Northern Indiana Region hospitals.

“Studies show that the longer patients are on bed rest, the sicker they become. Studies also show that early mobility is a safe, effective method to care for critically ill patients,” Nack said, adding, “Bed rest can cause more complications, including pneumonia, weakness and impairments that decrease long-term quality of life. A patient loses 3 percent of muscle strength for every day in bed.”

Nack serves as regional coordinator and led a multidisciplinary team to design and implement the program, which reduces overall patient time spent on ventilation, as well as how long they need to stay in a hospital.

“As part of our extensive research and studies, we devised a list of criteria patients need to meet to safely move out of bed. Now, 50 to 60 percent of our ICU patients are getting out of bed and we have a goal of 75 percent,” she said, adding the idea is to get the patient up on day one, if possible. For many, the first step is to get them to a chair.

“We know that early mobility is the best model of patient care. It involves collaboration among all health care disciplines – respiratory, physical and occupational therapists and nurses – a real team approach.”

A presentation of the program, titled, “Changing Paradigms in Acute Care,” resulted in a first-place award among 17 entries at the RIC’s Quality Fest 2014. The contest has been conducted since 2000 and identifies staff projects and improvements across the RIC system that demonstrate measureable and sustainable patient care results.

Since 2008, the RIC has been the umbrella organization for Franciscan Alliance hospitals’ rehabilitation services in Northwest Indiana.

“It was through our partnership with the Rehabilitation Institute of Chicago that we cast the vision to implement the early mobility program systemwide,” said Nack, who has been with Franciscan St. Anthony -Crown Point for 11 years. The initiative was launched at that hospital and now is being provided at Franciscan St. Anthony Health-Michigan City and Franciscan St. Margaret Health-Dyer and Hammond, as well.

Key members of Nack’s team in Crown Point are Arlene Santos, physical therapist; Rozanna Jamison-Hoskins, occupational therapist; Irene Copak, clinical nurse specialist; and Alicia Guex, manager of rehabilitation services. All of them echoed Nack’s passion about the benefits of early mobility.

Karen Ortmann, RIC regional executive director of rehabilitation services, asked Nack to lead the work group that led to the new program.

Added Nack, “Patients and their families can know that when they are being treated in a Franciscan Alliance ICU, they are receiving state-of-the-art, evidenced-based care from a highly skilled team dedicated to maximizing their long-term quality of life. It is structured to help patients get out of bed and preserve their ability to walk – to return them to the ability they had before. They can expect to need less time in the hospital and have a better physical and cognitive recovery.”

Photo: Barbara Goletz, of DeMotte, pushes a wheelchair while on a ventilator in the Franciscan St. Anthony Health-Crown Point Intensive Care Unit. She is a participant in the hospital’s recently implemented ICU early mobility initiative, which has proven to shorten patient hospital stays and otherwise aid in their recovery by getting them up and around sooner. Assisting her (from left) are Chris Ried, registered respiratory therapist; Rozanna Jamison-Hoskins, occupational therapist; Irene Copak, clinical nurse specialist; and Arlene Santos, physical therapist.