Evaluating the impact of Keep Your Move in the Tube (KYMITT) on patient AM-PAC scores and discharge disposition.

Abstract

Background: The Sarasota Memorial Health Care System (SMHCS) Acute Care Rehabilitation Team began implementing the Keep Your Move in the Tube (KYMITT) protocol in February 2023 to improve patient mobility and offer an alternative to traditional sternal precautions. The goal of KYMITT is for patients to remain within a safe zone (referred to as "the tube") rather than complying with time and weight restrictions, which are the cornerstone of traditional sternal precautions. In previous studies, KYMITT was associated with greater independence after surgery without placing patients at an increased risk of experiencing a surgical site infection.

Objective: To test the hypothesis that KYMITT is associated with greater patient mobility and independence, without increasing the risk of surgical complications.

Methods: Researchers at SMHCS analyzed records of 614 open-heart surgery patients (n = 293 in the traditional sternal precautions group and n = 321 in the KYMITT protocol group) to determine the differences in their Activity Measure for Post-Acute Care (AM-PAC) mobility scores.

Results: The average last-recorded AM-PAC score for the traditional sternal precautions group was significantly lower than for those receiving the KYMITT protocol (19.2 [95% CI: 18.86-19.62] vs. 20.0 [95% CI: 19.62-20.35], p = .006). For patients with at least two AM-PAC scores recorded, the difference was calculated for each patient's first to last AM-PAC score (AM-PAC delta). There was not a statistically significant difference between groups with an average improvement of 2.7 (95% CI: 2.30-3.09) for the traditional sternal precautions group compared to 3.1 (95% CI: 2.71-3.45) for the KYMITT protocol, p = .16 when comparing average AM-PAC delta.

Conclusion: Overall, during the 7 months that KYMITT was conducted hospital-wide, a significant increase in average last-recorded AM-PAC scores was observed month to month (slope = 0.45, 95% CI: 0.27-0.62, p < .001).