Electronic Health Record Tool to Promote Team Communication and Early Patient Mobility in the Intensive Care Unit

Robert J Anderson; Kathleen Sparbel; Rhonda N Barr; Kevin Doerschug; Susan Corbridge

doi:10.4037/ccn2018813

Electronic Health Record Tool to Promote Team Communication and Early Patient Mobility in the Intensive Care Unit

Crit Care Nurse. 2018 Dec;38(6):23-34. doi: 10.4037/ccn2018813.

Authors

Robert J Anderson¹, Kathleen Sparbel², Rhonda N Barr², Kevin Doerschug², Susan Corbridge²

Affiliations

¹ Robert J. Anderson is an advanced registered nurse practitioner in the intensive care unit, Mayo Clinic, Rochester, Minnesota. Kathleen Sparbel is Director of the College of Nursing, University of Illinois at Chicago, Quad Cities Campus, Moline, Illinois. Rhonda N. Barr is a staff physical therapist specializing in critical care in the medical intensive care unit, University of Iowa Hospitals and Clinics, Iowa City, Iowa. Kevin Doerschug is Medical Director in the medical intensive care unit at University of Iowa Hospitals and Clinics. Susan Corbridge is Associate Dean for Practice and Community Partnerships, College of Nursing, and a nurse practitioner, Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois. anderson.robert2@mayo.edu.
² Robert J. Anderson is an advanced registered nurse practitioner in the intensive care unit, Mayo Clinic, Rochester, Minnesota. Kathleen Sparbel is Director of the College of Nursing, University of Illinois at Chicago, Quad Cities Campus, Moline, Illinois. Rhonda N. Barr is a staff physical therapist specializing in critical care in the medical intensive care unit, University of Iowa Hospitals and Clinics, Iowa City, Iowa. Kevin Doerschug is Medical Director in the medical intensive care unit at University of Iowa Hospitals and Clinics. Susan Corbridge is Associate Dean for Practice and Community Partnerships, College of Nursing, and a nurse practitioner, Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.

PMID: 30504495
DOI: 10.4037/ccn2018813

Abstract

Background: Intensive care unit early mobility programs improve patients' outcomes while reducing costs for both patients and institutions. Inadequate interprofessional communication is a known barrier to achieving good early mobility program outcomes. Electronic health record communication tools promoting interprofessional communication have demonstrated improved patient outcomes, but have not been evaluated for mobility in the intensive care unit.

Objectives: To implement an early mobility collaboration program in an existing early mobility program, consisting of protocol education and an electronic health record tool designed to improve interprofessional communication and collaboration.

Methods: In phase 1, staff members viewed an online educational module, the existing mobility protocol, and the "Mobility Levels" grading scale. In phase 2, an electronic health record communication tool displayed recently recorded mobility levels to all care providers. Staff knowledge of the early mobility program and perceptions of mobility-related communication were assessed by survey; patient outcomes including mobility goals, mechanical ventilation time, length of intensive care unit stay, and cost were assessed by records review.

Results: Statistically significant increases were found for staff satisfaction with mobility-related communication (P < .001) and communication frequency (P = .02), but not for staff knowledge (P = .28). Hours to achievement of mobility goal (P = .02) and length of intensive care unit stay (P = .02) decreased significantly. Average ventilation time decreased by 27 hours. Discharge recommendations at higher functional levels increased. Total intensive care unit cost decreased significantly (-39.5%; P = .04).

Conclusions: Interprofessional communication and collaboration can lead to improved outcomes. Combining routine educational reviews and an electronic health record communication tool may improve patient and system outcomes for intensive care unit early mobility program patients.

MeSH terms

Communication*
Critical Care / methods*
Critical Care / standards*
Electronic Health Records / standards*
Guidelines as Topic*
Humans
Intensive Care Units
Interprofessional Relations*
Mobility Limitation
Patient Care Team*
Surveys and Questionnaires