If you missed my latest podcast episode last week, here’s a summary of the thoughts that have been burning in my mind and heart. Rapid implementation without the right education, support, and strategy can turn a promising ICU initiative into the flavor of the week. Revolutionary change in the ICU does not happen because leaders
Why ICU Champions Alone Cannot Create Lasting ICU Culture Change
Most ICU culture change begins with someone who sees that patients could receive better care. It may be a nurse who understands the consequences of deep sedation, a physical therapist who sees patients losing strength every day they remain immobile, or any other clinician who recognizes how the ABCDEF Bundle can improve survival and recovery.
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Why ICU Patient Outcomes Must Go Beyond Survival
Improving ICU patient outcomes cannot stop at survival. Every ICU team understands the urgency of keeping a patient alive, whether they’re suffering from shock, respiratory failure, sepsis, trauma, surgery, or multi-organ failure. But survival alone does not tell the whole story. A patient can survive the ICU and still leave with serious weakness, delirium-related trauma,
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Checking the Boxes but Missing the Mark: ICU Rounds
After working in 11 ICUs and training 14 others, I have seen multidisciplinary rounds conducted in many different ways. And I’ve also witnessed how easy it is to check the boxes but still miss the mark. Even in teams that are more progressive with the ABCDEF Bundle who “check the boxes” during ICU rounds, the
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Mobility vs. Positioning in the ICU: Are We Dangerously Confused?
We cannot fix what we cannot confront. So, bear with me as I delve into some hard realities within the ICU community. I am often told, “We do early mobility in our ICU!” However, when I probe deeper into the “mobility” provided, I find that the most common interventions that are considered mobility include: Chair
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Daily Doses of Gravity in the ICU
Throughout my journey in this ICU revolution, I have come to learn that the simplest concepts can be the most profound and the most important. This is going to sound too basic to be significant but hear me out. Gravity needs to be considered a standard “medication” in the ICU. Gravity is the grounding force
Lessons Learned From the TEAM Study
“See? From this we see that mobility does nothing!” This is the common rebuttal that I have received from at least a few physicians in every single ICU I have trained since the TEAM Study was published in The New England Journal of Medicine in 2022. There is often a sparkle of mischief in their
Raging Tigers and Merciful Angels: The Fight to Humanize Critical Care
Medicine is a field of evolution with a continuous trajectory of exploration, discovery, change, and progress. And this perpetual pattern has been just as reliable as the predictable resistance that comes with change. Past Revolutionists Who Fought to Humanize Critical Care This was demonstrated in the journey of Ignaz Semmelweis (pictured above), a Hungarian
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Why ICU Teams Need Expert ABCDEF Bundle Consulting
In my experience, teaching ICU clinicians about the ABCDEF Bundle can sometimes feel like trying to explain water to a fish. Just as a fish has no context to understand the water it’s swimming in, ICU teams may not always clearly see the preventable harm surrounding them. When clinicians are immersed in the daily realities
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Why Gradual ABCDEF Bundle Implementation Often Results in a Failure to Launch
“Let’s introduce the bundle gradually. We don’t want to overwhelm anyone. Let’s see what the team is willing to do. We can start with awakening and breathing trials, then tackle the rest once we have those down.” This kind of conversation has echoed through medical organizations and clinical leadership teams for years. It’s a logical
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Before Kali, our hospital struggled with overly-sedated patients and lack of early mobility. Despite multiple efforts to change the culture, we were at a standstill. In one hour, Kali was able to ignite a flurry of conversations regarding her experience with the Awake and Walking ICU™ and this immediately led to a change in clinical practice.
Patients with less sedation and other neurotoxic medications are spending fewer days on the ventilator. If you are considering starting an ICU early mobility program at your hospital, your first step needs to be to consult with Kali and absorb as much information as you can!
Matthew McClain, DPT
Florida, USA
Perception Versus Reality: Debunking The Myths About Medically-Induced Comas
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