At the Henry Ford Health System in Detroit, PTs started an early-rehab program in the medical intensive care unit (MICU).
As beneficial as movement can be for patients while they still are on ventilation, sometimes mobility is easier said than done. It can take 4 or 5 clinicians to manage the lines and vents to help a single patient in the MICU walk. PTs at Henry Ford wanted to use a walker designed for high-acuity patients to better accommodate those on ventilation. Some PTs saw such walkers demonstrated at APTA’s 2015 Combined Sections Meeting, but none of the walkers met all their needs, so they decided to construct their own.
A team of 2 PTs and 2 occupational therapists did the planning. They drew together elements they deemed important and combined their ideas to create what, in their minds, was the ideal walker. “We knew that we needed weight requirements and easy maneuverability,” says Romina Bello, PT, DPT, the team’s lead PT.
She and her colleagues shared their ideas with product designers at the Henry Ford Innovation Institute, who then created a model from PVC pipe. The PTs themselves then tested the prototype.
Of course, testing with patients who were on ventilators was paramount. The institute provided funding, and Henry Ford’s clinical engineering department built a stronger model out of industrial-grade materials. The health system now is testing the walker, with a goal of having 50 to 100 patients use it during this phase.
Patients in the MICU are attached to many different lines. Keeping those lines safe and intact is crucial. The high-acuity-patient walker therefore features flexible tubing—if a patient needs to sit quickly, all of the attached lines can accommodate the movement. “There’s no fear that the patient will lose a crucial line during therapy,” Bello says. The incorporation of a seat into the walker gives patients an added sense of security, she notes.
The main goal of the walker is increased patient walking speed. “The reaction from the other health disciplines has been really good,” Bello says. “We have doctors and nurses gathering around to watch patients walk around the unit with the walker’s assistance, and cheering for them.”
A secondary goal is to require only 2 clinicians—a PT and a respiratory therapist—to accompany each patient, which would give PTs additional time to treat other patients.
“We haven’t had to make a lot of adjustments yet,” Bello says. “The walker’s been working quite well.”