The Evaluation of a Multidisciplinary Intervention to Promote Early Mobilization for Patients in the Intensive Care Unit

Purpose: No published studies have described implementing a Johns Hopkins Activity and Mobility Promotion (JH-AMP) -inspired early mobilization initiative in an intensive care unit (ICU) serving a racially and socioeconomically diverse patient population. We hypothesized that a JH-AMP -modeled intervention would increase the proportion of patients achieving a Johns Hopkins Highest Level of Mobility (JH-HLM) ≥3, a threshold for clinically meaningful mobility in the ICU, compared with pre-intervention care. Methods: We conducted a retrospective review of a multidisciplinary quality improvement project. ICU admissions from April 4, 2021 to April 3, 2022 served as the pre-intervention group (N=769), and admissions from April 4, 2022 to April 4, 2023 served as the intervention group (N=930). The primary outcome was the percentage of patients who achieved JH-HLM ≥3 at any point during their ICU admission. Results: Patients in the intervention group were more likely to achieve JH-HLM ≥3 during their ICU stay (35.0% vs 24.1%; unadjusted OR 1.70, 95% CI 1.37 -2.10; P<.0001). After adjustment for potential confounders, this association remained significant (adjusted OR 2.16, 95% CI 1.58 -2.95; P<.0001). Conclusions: Implementation of this multidisciplinary intervention improved mobility among patients who are critically ill ICU and supports feasibility of early mobility practices in diverse settings.