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Clin Chest Med. 2015 Sep;36(3):431-40. doi: 10.1016/j.ccm.2015.05.006.

Barriers and Challenges to the Successful Implementation of an Intensive Care Unit Mobility Program: Understanding Systems and Human Factors in Search for Practical Solutions.

Author information

1
Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA. Electronic address: shyoko.honiden@yale.edu.
2
Section of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Yale University School of Medicine, 300 Cedar Street, PO Box 208057, New Haven, CT 06520-8057, USA.

Abstract

ICU-acquired weakness is a common problem and carries significant morbidity. Despite evidence that early mobility can mitigate this, implementation outside of the research setting is lagging. Understanding barriers at the systems as well as individual level is a crucial step in successful implementation of an ICU mobility program. This includes taking inventory of waste, overburden and inconsistencies in the work environment. Appreciating regulative, normative as well as cultural forces at work is critical. Finally, key personnel, which include organizational leaders, innovation champions and end users of the proposed change need to be accounted for at each step during program implementation.

KEYWORDS:

Critical illness; ICU mobility; Intensive care unit; Quality improvement

PMID:
26304280
DOI:
10.1016/j.ccm.2015.05.006
[Indexed for MEDLINE]

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