The Critical Care Center has numerous research projects underway, learn more about breakthroughs in a few of our recent projects.
Recent Research Projects
Patient care and transfer in the Neurosciences ICU
In February 2011, the Critical Care Center convened a multidisciplinary team to improve transfer of patient care between the Mass General Neurosurgery Service and the Neurosciences ICU. Investigators from the Departments of Neurology, Anaesthesia, Critical Care & Pain Medicine, Surgery, Patient Care Services (Nursing) and hospital administration collaborated to address this important patient quality and safety imperative. The multidisciplinary team met every week for four months to develop a safe and effective patient transfer process. A transfer aid was created to help standardize and streamline transfer, with the goal of improving communication between the staff from the Operating Room and Neurosciences ICU. Significant improvements were observed across several key steps in the handoff process, including the presence of all necessary clinicians at the time of patient transfer, the performance of a neurological exam during the patient handoff, and the verbal report of the patient care plan summary at the end of the handoff. The results of this project were presented at the annual international Neurocritical Care Society Conference, September 23, 2011, Montreal, Canada.
Surgical ICU Optimal Mobility Score (SOMS)
Prolonged patient immobility in ICU’s is common and can contribute to muscle weakness, which may impair functional independence long after hospital discharge. To prevent this, we have learned that it is important to keep sedation medications to a minimum and to start physical therapy early during the ICU stay. This therapy is called “early mobilization” and consists of sitting patients at the edge of their bed, transferring out of bed to chair, gait training, and in-bed cycling exercises for those who cannot sit upright. We wondered whether early mobilization also could be applied to our sickest patients after surgery or trauma, who often have surgical drains, pain from abdominal and chest wounds, or bone and muscle trauma. To answer this question, we developed the Surgical ICU Optimal Mobility Score (SOMS). The SOMS consists of a simple numeric scale that describes each patient’s ability to move which in turn is linked to an algorithm developed to select the optimal activity level. We discovered that SOMS is a reliable and valid tool to predict mortality, ICU, and hospital length of stay in surgical critically ill patients presenting without preexisting impairment of functional mobility. We believe that SOMS-guided, early mobilization therapy has the potential to significantly improve the outcome and quality of life of surgical ICU patients. Future efforts will be focused on conducting follow-up studies to better describe the patient benefit and testing the applicability of these findings to patients in other centers.