B55-29 Move It to Improve It! A Quality Improvement Initiated to Enhance Early Mobilization in the Medical ICU

Abstract Rationale Early mobilization in the intensive care unit (ICU) is associated with reduced delirium, shorter length of stay, and improved functional recovery. Despite strong evidence, immobility remains prevalent in the ICU’s across the world, largely due to system-level and resource-related barriers. A quality improvement (QI) project was implemented in the medical ICU to enhance early mobilization practices and overcome barriers identified by frontline staff. Methods Patient is admitted to MICU between April and June 2025 who are deemed suitable for mobilization by Johns Hopkins highest level of mobility (JH-HLM) score = 4 (out of bed) were included in the study. Baseline mobility data and preintervention survey with the MICU nurses identifying perceived barriers were obtained before implementation. The intervention included: Prescriptive mobility discussions during the multidisciplinary rounds emphasizing mobility goals beyond physical/Occupational Therapy orders, Implementation of daily mobility rounds with visual tracking boards, and fellow lead mobility check during evening reviews. Postintervention data captured by daily JH HLM scores and documentation of mobility goals with primary outcome being the proportion of patient’s achieving mobility goal of JH HLM score =4 Results A total of 253 patient encounters were analyzed in the 14-day pre-interview.. The major barriers to mobilization identified by the preintervention survey included limited staff/resources, lack of recliners and time constraint. Following intervention implementation, the proportion of patients achieving a JH-HLM for increased from 26% at baseline to 50% postintervention. Staff engagement in multidisciplinary communication regarding mobility targets improved and nursing documentation of daily mobility goals became more consistent. No adverse events related to mobilization were reported. Conclusions A structured, multidisciplinary approach that integrates prescriptive mobility discussions, dedicated rounds and visual accountability significantly improved early mobilization rates in the MICU. Future work will evaluate sustainability and expansion of this intervention to other ICU’s and determination of decrease in delirium rates of our MICUs in the future. This abstract is funded by: none