Patient Safety Conversations | Patient Mobility Program at The Johns Hopkins Hospital

[MUSIC] The only way we’re going to end
preventable harm is if every one of our employees gets
involved in this work. And we have a great story
to share with you today. Help me understand, why is it
important that patients are mobile when they’re in the hospital?>>So we know that when
patients are on bed rest, that it leads to weakness and worse
outcomes upon hospital discharge. So we know that patients in the ICU
were being moved a lot less, so we thought it would be important
to try to get them up and moving. And knowing that,
if they could get up and move, that they would have
improved outcomes.>>Fantastic, and how did you identify mobility as
a potentially preventable harm?>>There was a study done at
Johns Hopkins in 2006 that looked at moving patients in the ICU. And they found that when they get
them moving, any sort of mobility, that they had improved outcomes and
mobility rates at discharge, and also decreased time in the ICU and
on the mechanical ventilator.>>Wow, that’s impressive! How did you go about
creating this program?>>So we started with a basic
mobility scale looking from rolling to sitting, standing and
up to walking. And then we used that as
a collaboration with nurses to set a daily goal for patients of what sort of
mobility they can do for the day.>>And Cindy, what role are nurses
playing in this program?>>So we consider our nurses
part of the healthcare team, part of the mobility
team especially. And there are some activities that
our patients can do that nurses can do with them. We don’t necessarily need
a PT consult for everybody. So there are some things as simple
as getting a patient out of the bed to the chair. We use PT for our sicker
patients and our more acute patients as a great resource for
what our own patients can do.>>And I understand you’re
even engaging families in this kind of work.>>Family members are definitely a
part of the healthcare team as well. Part of the tablet that we have
has a family involvement menu, and they can help participate with
activities that are anything from pushing a chair to doing
bed activities for the patient. We really want them engaged in their
loved ones’ healthcare as well.>>Amy, I heard you put
this program on a tablet. Tell me a little bit about that.>>Sure, so every morning we
collaborate with the bedside nurse. And we set a mobility goal for
the patient. And that could be, for example,
sitting edge of the bed. And then we track that
at the end of the day, if the patient met their goal. It’s also a great way to look at if
they’re meeting their goals over time and
a great way to progress their goals. So say Cindy said,
the patient sat up yesterday. Let’s try to get
them standing today.>>So it sounds like you’re
actually tracking patients’ metrics with this?>>Yeah, absolutely.>>Well, and how do these metrics
inform your performance as a nurse?>>Well, it’s great to have a whole
team on the same level in terms of what the goal is gonna be. It’s great to also know why maybe
a patient didn’t meet that goal. We also can track if the patient
condition wasn’t appropriate. If we didn’t have enough activity. If we didn’t have enough staff,
if we didn’t have enough equipment. Or maybe the patient just
refused that day, but it’s good to be able to
track that information.>>This mobility program is just so
impressive. What kind of results are you seeing?>>So, we’re seeing that more
patients are reaching their highest level of mobility, which is walking
250 feet or more, and that they’re having improved mobility and
outcomes upon hospital discharge.>>What a great example of how
the only way we’ll make care safe is that the whole care team comes
together and works together for their patients and their loved ones. Please share your stories with
us at the Armstrong institute. [MUSIC]

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