THE BENEFITS OF EARLY MOBILIZATION Stimulates motivation to recover Improves mental state and clarity of thinking Maintains heart function Helps you breathe more freely This information sheet presents Reduces pressure that causes skin deterioration significant benefits of early mobilization. Additionally, it is Helps bowel movement and function important to remember that early mobilization is both safe and feasible. Increases muscle tone and blood circulation throughout the entire body • Promotes independence Prevents achiness, joint stiffness and contractures • Improves outcomes • Decreases length of stay in hospital Prevents blood clots (deep vein thrombses) • Facilitates returning to work Graphic: Dr. Nancy McLaughlin / Vigg financial data across the UC sites. One of the projects has focused on reducing atrial fibrillation, a postoperative arrhythmia that can cause stroke, keep patients in the hospital longer and require expensive and invasive care. The group has found that assigning patients to low-, intermediate- and high-risk categories based on risk factors and then treating high-risk patients more aggressively with prophylactic therapy reduces the incidence of atrial fibrillation more efficiently. Other areas being addressed by the consortium include blood conservation, swallowing difficulties after heart- surgery intubations and protocols for discharge and follow-up to prevent hospital readmissions. “The established norms for treatment represent the status quo,” Dr. Shemin notes. “By querying our robust database to look for trends and assess what happens when patients are treated outside the established norms, we can find ways to improve on practice guidelines.” THE CONCEPT OF STANDARDIZING CARE-PATHWAY protocols to reduce unsupported variations and improve quality isn’t new. Nor is UCLA’s leadership in the effort. A similar movement took hold in the 1990s, with the UCLA kidney-transplant program serving as a national benchmark for its ability to produce the best results with the greatest efficiency through standardized practices. UCLA’s place at the forefront of the movement has remained constant. This was illustrated most recently when UCLA Health was selected by the Centers for Medicare and Medicaid Services (CMS) as the only academic medical center in California to sponsor and participate in the federal government’s Medicare Shared Savings Program as an accountable care organization — working with the CMS to enhance care coordination as a way to provide high-quality service and care to Medicare fee-for-service beneficiaries while reining in costs. What’s changed in the last decade, both nationally and at UCLA, has been the enhanced focus on efficiency in the face of growing concerns about healthcare spending. “We have not been on a sustainable path,” says Dr. Skootsky. “Society is telling the healthcare industry that we have to figure out ways of doing this better and less expensively. With a standardized, evidence-based approach to care, we can have a higher level of confidence that we aren’t utilizing unnecessary resources.” Wide variations in cost for the same procedures across institutions, and even within the same institution, provide strong evidence that new efficiencies can be achieved. “You can study 20 different surgeons and find that the costs of delivering “By querying our robust database to look for trends and assess what happens when patients are treated outside the established norms, we can find ways to improve on practice guidelines.” U MAGAZINE 29