80% of physicians support automatic orders for mobilization([FOOTNOTE=Jolley SE, Regan-Baggs J, Dickson RP, Hough CL. Medical intensive care unit clinician attitudes and perceived barriers towards early mobilization of critically ill patients: a cross-sectional survey study. BMCAnesthesiol. 2014;14:84. doi: 10.1186/1471-2253-14-84],[ANCHOR=],[LINK=])

Intensivists oversee ICU patient care. From this vantage, they can prioritize early mobility treatments through practices including:

  • Automatic referrals to physical therapy
  • Spontaneous awakening and breathing trials
  • Scheduling procedures around physical therapy([FOOTNOTE=Cameron S, Ball I, Cepinskas G, et al. Early mobilization in the critical care unit: a review of adult and pediatric literature. J Crit Care. 2015;30(4):664–672. doi: 10.1016/j.jcrc.2015.03.032],[ANCHOR=],[LINK=])


Awareness of the benefits of early mobility in the ICU continues to grow, but actual implementation of early mobility protocols lags behind.([FOOTNOTE=Bakhru RN, Wiebe DJ, McWilliams DJ, Spuhler VJ, Schweickert, WO. An environmental scan for early mobilization practices in U.S. ICUs. Crit Care Med. 2015;43(11):2360–2369. doi: 10.1097/CCM.0000000000001262],[ANCHOR=],[LINK=])

Intensivists can champion early mobility by:

  • Developing protocols or adapting existing ones for their ICUs
  • Incorporating patient mobility status into clinical rounds
  • Working with ICU nurses and physical therapists to prioritize early mobility
  • Including all team members in patient care planning.

Intensivists have options for getting their patients moving.


50% lower chance of delirium using ABCDEF bundle([FOOTNOTE=*Vs. control group (usual care). Balas MC, EE Vasilevskis, Olsen KM, et al. Effectiveness and safety of the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility (ABCDE) bundle. Crit Care Med. 2014;42(5):1024–1036. doi:10.1097/CCM.0000000000000129],[ANCHOR=],[LINK=])*

When planning a patient’s care regimen, intensivists can use interventions designed to work in concert. The ABCDEF bundle offers one such management strategy. It includes:

  • Awakening and breathing coordination
  • Delirium monitoring/management
  • Early exercise/mobility
  • Family engagement and empowerment

Caregivers using this bundle have reported improved patient outcomes, including less time on mechanical ventilation, less delirium, and greater mobility.4