Enhancing early mobilization in critically ill patients through multidisciplinary rounds: A process-focused...

Area of Science:

• Critical Care Medicine
• Physical Therapy
• Healthcare Management

Background:

• Early mobilization (EM) is crucial for critically ill patients but faces implementation barriers in intensive care units (ICUs).
• Multidisciplinary rounds (MDR) are a potential strategy to enhance EM practices.
• Understanding the impact of MDR on EM initiation is essential for improving patient outcomes.

Purpose of the Study:

• To evaluate the effect of multidisciplinary rounds (MDR) on the initiation of early mobilization (EM) in the ICU.
• To assess whether MDR implementation influences the rate and timing of physical therapy (PT) for ICU patients.

Main Methods:

• A retrospective observational study was conducted in a tertiary university medical center's ICU.
• Patients were divided into pre-MDR (n=110) and post-MDR (n=191) groups based on admission dates.
• Data on EM initiation and PT consultation were analyzed comparing the two phases.

Main Results:

• EM practice increased significantly post-MDR implementation (39.8% vs. 20.9%, p=0.001), especially in mechanically ventilated patients.
• The median time to physical therapy (PT) initiation decreased from 6.0 to 3.0 days (p<0.001).
• MDR was associated with an 84% higher likelihood of initiating EM (aRR 1.84).

Conclusions:

• Multidisciplinary rounds (MDR) are pivotal in enhancing early mobilization (EM) for ICU patients.
• MDR effectively addresses barriers hindering EM implementation in critical care.
• The study underscores the value of MDR in improving PT initiation and EM rates.