Researchers from Johns Hopkins medicine found that quality improvement changes, which included early physical therapy, made in the ICU unit were still in practice 5 years later.

 There are many barriers to overcome in incorporating physical rehabilitation in the ICU, but sustaining such a quality improvement project is really about changing culture. “Most people who work in an ICU were trained to think that we were supposed to care for patients by deeply sedating them and giving them bed rest,” says Needham. Introducing active physical therapy even while patients are on mechanical ventilation “really takes everything we’ve known — including how we’ve designed our intensive care units — and turns it on its head.”

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