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Solutions

Activity & Mobility Promotion (AMP)—ICU

A multi-disciplinary approach to critical care for adults

 

Dale Needham, M.D. Introduces AMP—ICU


THE CHALLENGE

The problem with the current standard of care in many adult ICUs is the epidemic of deep sedation, bed-rest, and immobility. Survivors of this approach to critical care too often face post-intensive care syndrome, which includes long-term physical, cognitive, and psychological impairments.

THE SOLUTION

The ICU Early Rehabilitation Program is a multi-disciplinary approach to critical care for adults that calls for early intervention so patients are wider awake and moving. To help hospitals facilitate this paradigm shift in ICU care, the ICU Early Rehabilitation Program provides both hospital and unit leaders as well as front-line providers with tools to design and implement a structured QI process including: how to put together a multi-disciplinary team to affect and sustain culture change; how to address existing culture and practice barriers; and how to design and utilize a simple metric so you can evaluate your progress.

AMP—ICU TOOLS AND RESOURCES
OUTCOMES

Johns Hopkins clinical researchers have demonstrated that consistent application of this early rehabilitation model has significantly improved patient and family satisfaction, improved short-and long-term patient outcomes, and reduced length of stay and readmission.


DETAILS

When a patient is in the ICU, the combination of critical illness and long periods of immobility and bed rest causes early and rapid muscle wasting, with associated weakness and physical impairments that can last for years. For many patients, an ICU stay also can cause delirium and long-term cognitive impairments. As a consequence of these and other impairments, approximately half of all ICU survivors do not return to work by one year after critical illness, with many of them experiencing ongoing or repeated physical declines during their post-discharge “recovery” period.

How can we improve these outcomes?

The Johns Hopkins Adult ICU Early Rehabilitation program is an evidence-based, multi-disciplinary intervention that has been proven safe for ICU patients, even those requiring endotracheal tubes, continuous hemodialysis, and femoral catheters. The program’s goal is to reduce deep sedation and get patients mobilized and engaged in functional activities. With early intervention, started within a few days of initiating mechanical ventilation, patients experience less hospital-acquired impairments, have shorter length of stay, and are more often discharged to their home rather than to a skilled nursing or rehabilitation facility.

Changing culture and implementing this new paradigm of adult ICU care can be challenging. The Johns Hopkins program provides the tools and the in-person training required to successfully address barriers to successful implementation and to support clinical teams as they systematically implement this approach to improve patient care.

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WHY CHOOSE A JOHNS HOPKINS SOLUTION?

For more than 125 years, Johns Hopkins has led the way in both biomedical discovery and patient and population care. Faculty research most often leads to innovative protocols, programs and services, establishing the standard by which others follow and build upon. Our goal: make these innovations available beyond our walls to improve the health outcomes of individuals and populations—within our community and throughout the world.

QUESTIONS?

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