Sep 2, 2016

Interview Transcript

Announcer: These are the conversations happening inside healthcare that are going to transform healthcare. The Healthcare Insider is on The Scope.

Interviewer: What is a culture of mobility? Well, the old way, when somebody was sick is, you lay in bed, you rest, you recover, you get better, but the new way of thinking is get up and get moving as soon as possible, and it's a culture shift for doctors and patients. Robin Marcus is the Chief Wellness Officer at University of Utah Healthcare, and as part of Imagine Perfect Care, there's this concept that your department, I was going to say you developed, but I don't think you were solely responsible for, called the culture of mobility. Explain what that means.

Robin: So, the culture of mobility is really just what you said, Scot. Patients are used to the fact that if they're sick, they go to the hospital, and they should stay in bed. And in reality, what we've found over the years, and there's actually really good evidence on this, is that there's something called hospital-associated deconditioning, and patients actually get worse while they're getting better in the hospital. So, the culture shift now is we need to teach patients, doctors, therapists, nurses, that if there's no reason to stay in bed, we can actually make people better while they're getting their healthcare condition taken care of, we can maintain their activity, or even increase it.

Interviewer: So tell me, how did this philosophy come here to University of Utah Healthcare, because there had to be that first person in that first moment, right?

Robin: Yeah, and actually, I can attribute this to some of our physicians, Dr. Joe Tonna, and our therapist, Doug Benson, Chris Noren, who's the director of the inpatient side of things. They actually started thinking about this a few years ago. They attended a few conferences. Johns Hopkins has been doing this for awhile. And they said why can't we do this here? In fact, why can't we even do it better here?

Interviewer: And so, was it a hard sell or was it a pretty easy sell? Do you know?

Robin: You know, actually, we're in process right now. But it's becoming an easier sell, because as we're learning more about physical activity in general, there's no reason to limit the ability of patients who are in the hospital to benefit from increased physical activity, just like everybody else. So, as far as the sell right now, we're actually starting to show data that our patients' length of stay is decreasing, their satisfaction is good, and an added bonus is the provider satisfaction is even higher.

Interviewer: So you have some case studies that I read about about some specific instances of how this has been effective. Choose one of those and tell me that story.

Robin: Well, there are patients who are in our intensive care units who are actually quite ill, and they can still stand up, and they can still walk, but they're hooked to machines. So a case in particular is taking a patient on a machine, a portable machine, and getting them up and moving, and not only up and moving, but getting them outside, because the other thing that we know is being outside in nature is better than being inside.

Interviewer: And research shows this?

Robin: Absolutely.

Interviewer: Wow. Okay. So you get them up, you get them outside, you get them moving around, and the patients, the doctors are like, "Oh, we shouldn't be doing that."

Robin: Well, yeah. We have to show that it's safe, and I think rightly so. At first, people were pretty nervous about doing some of this. And there are still some patients that obviously we shouldn't do this with, but there are a lot of patients that we can get up and get moving, and it's safe, and they're happy, and they get better faster.

Interviewer: So if somebody's listening that works at an institution where they quite haven't adopted this philosophy yet, what would your advice be to them to kind of start making that happen?

Robin: You know, I think if you're a provider, there's a lot of literature now that you could start to look at to guide you in how to do this in your own hospital system. I think that looking at instituting outcome measures in your system across the board helps, because you can have some baseline information, and then implement.

Interviewer: What advice would you have for that person after they've done their due diligence and the research, just because you've been through the process?

Robin: You know, I think the biggest thing is engage as many stakeholders as you can and get people's ideas, and you'll get buy-in after you can provide some evidence that this is a good thing. And then put the team together, and I think you'll have people banging down your door to help.

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