Hospitals in pursuit of excellence

Implementation of Nursing Mobility Protocol to Foster Consistent Earlier Mobility of Patients in an Intensive Care Unit

Variation and delays in the early mobilization of patients in the ICU can result in an increased length of stay, poorer functional outcomes and an increased cost-per-patient stay. A team was created to develop a consistent process for patient mobilization for physicians and nursing staff to follow to reduce the time from ICU admission to mobilization, improve patients' functional status at time of discharge from the ICU and from the hospital, and reduce ICU length of stay. Baseline data showed ICU admission to first time in chair position averaged 74 hours. The primary improvement intervention was the creation of the ICU Nursing Mobility Protocol, which was driven by evidence-based practice and included four distinct levels of activity and specific criteria to move patients to higher levels of activity. With this intervention, ICU admission to first time in the chair position improved by 57 percent. Functional outcomes for patients also improved.

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This case study is part of the Illinois Hospital Association's annual quality awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals in continually improving and transforming health care in the state. These hospitals are improving health by striving to achieve the Triple Aim--improving the patient experience of care (including quality and satisfaction); improving the health of populations; and reducing the per capita cost of health care.

Award recipients achieve measurable and meaningful progress in providing care that is:

• Safe
• Timely
• Effective
• Efficient
• Equitable
• Patient-centered

(The Institute of Medicine's six aims for improvement.)

Contact: Charles Callahan, executive vice president and chief operation officer,  (217) 788-3000