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The transformative power of early mobilization in acute care settings

An often-overlooked approach to enhance patient outcomes and healthcare efficiency

Matt Wilson, DPT,
Matt Wilson, DPT,
Clinical & Software Engineer
February 20, 2024

Early mobilization in the hospital is a proactive strategy aimed at getting patients moving as soon as medically feasible after admission. This approach, integral to modern patient care, involves physical activities tailored to individual patient needs — ranging from sitting up, to standing, to walking and engaging in specific exercises. The goal of early mobilization is to counteract the negative effects of prolonged bed rest, which include muscle weakness, decreased lung function, and psychological impacts.

Research underscores the effectiveness of early mobilization in enhancing patient recovery, reducing hospital length of stay, and improving functional outcomes. This approach reflects a paradigm shift in healthcare, emphasizing the critical role of movement in the recovery process across diverse patient populations. Recognizing its broad applicability and profound benefits, acute care hospitals are increasingly aware of the importance of early mobilization, signaling a pivotal shift in the approach to patient care.

This adoption of early mobilization in hospitals extends its benefits well beyond the confines of the Intensive Care Unit (ICU) to a much wider patient demographic. Championed by a diverse team of healthcare professionals, including physical therapists, nurses, physicians, and hospital administrators, this initiative places a strong emphasis on mobility as a core component of the recovery process. Beyond the significant financial benefits, early mobilization stands out for its profound positive impact on patient outcomes and wellbeing.

Empowering patients through early mobilization

Studies have shown that initiating mobility interventions soon after admission can significantly reduce the risks associated with prolonged bed rest, such as muscle atrophy, decreased cardiovascular endurance, and psychological impacts like reduced motivation and feelings of isolation. The benefits of integrating early mobilization into patient care are well documented. Research published in Critical Care Medicine and The Lancet concluded that patients in early mobility programs often experience shorter hospital stays, reduced incidence of delirium, and improved functional outcomes. These enhancements in recovery not only elevate the patient's quality of life but are also associated with a decreased need for facility-based rehabilitation services post discharge, underscoring the profound impact of early mobilization on the holistic wellbeing of patients.

Financial implications for hospitals

With hospitals across the nation facing capacity constraints, approaches to improve throughput are more important than ever. Early mobilization has been demonstrated to shorten hospital length of stay and ensure the patient can be discharged as soon as medically cleared to do so. Furthermore, early mobilization contributes to success under value-based contracts, under which hospitals are financially incentivized to reduce reliance on high-cost post-acute settings such as skilled nursing facilities and specialized rehabilitation hospitals.

A unified approach to patient care

The future of early mobilization in acute care is promising, with a growing recognition of its role in enhancing patient outcomes, boosting hospital efficiency, and controlling total costs of care. Embracing a multidisciplinary approach is essential. Together, we can create a care environment where early mobilization is an integral and standardized part of patient care, rather than an optional intervention.

References

1. Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008;36(8):2238-2243. doi:10.1097/CCM.0b013e318180b90e

2. Schaller SJ, Anstey M, Blobner M, et al. Early, goal-directed mobilisation in the surgical intensive care unit: a randomised controlled trial. Lancet. 2016;388(10052):1377-1388. doi:10.1016/S0140-6736(16)31637-3

3. Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomised controlled trial. Lancet. 2009;373(9678):1874-1882. doi:10.1016/S0140-6736(09)60658-9

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