Length of Stay and Early Mobilization of ICU patients

Client: New York-Presbyterian Hospital (Length of Stay)
Faculty: Anthony Kovner, John Donnellan
Team: Christine Alvarez, Monica Blanche, Mary May Saulan, Mari Lynne Silverberg, Diane Welsh
Year: 2012
As part of the mission to deliver the highest quality, safest and most compassionate care, the New York Presbyterian HERCULES or Hospital Efficiency, Revenue Cycle, Clinical Utilization, Length of Stay (LOS), and Enhanced Sourcing initiative has identified opportunities to improve patient outcomes while reducing costs. A primary focus to reduce the LOS centered on early mobilization of the ICU patient. The Capstone LOS team assessed characteristics conducive to successful implementation of an early mobilization program. A retrospective chart review of specific metrics on sedation, pain, activity levels, and physical therapy was conducted on charts from six ICU's inclusive of the Cornell and Columbia campuses. In addition, focus groups were conducted in these ICU's using a multi-disciplinary approach to assess perceived barriers to early mobilization. Physician, Nursing, Respiratory Therapy, and Physical/Occupational Therapy front line staff contributed to the discussion. The results of the analysis provided a recommendation for a model unit with the best opportunity for success to reduce the LOS through early mobilization. This will enhance the second stage roll-out in the ICUs not initially included in the original intervention.