KKH Implements Early Mobilisation Programme for Critically Ill Children
The Let’s MoveEM initiative uses early exercise and family support to improve paediatric recovery.
1Innovative Recovery Strategy
KK Women’s and Children’s Hospital in Singapore has launched the Let’s MoveEM programme to accelerate recovery for critically ill children. By prioritising early mobilisation within 72 hours of admission, the hospital aims to mitigate long-term physical and mental impairments. This approach shifts focus from purely medical intervention to holistic patient rehabilitation.
2Addressing Post-Intensive Care Syndrome
Post-Intensive Care Syndrome affects between 50% and 80% of ICU survivors, leading to persistent learning and mental health challenges. KKH doctors identified this risk, prompting a shift away from traditional, sedentary ICU care. The programme systematically screens for delirium, treating it as a vital sign alongside blood pressure and temperature.
3Delirium as a Vital Sign
Delirium causes acute confusion and disorientation, often indicating severe stress from infection or medication. KKH data shows 60% of critically ill children develop this condition, which correlates with longer mechanical ventilation and hospital stays. Systematic screening allows medical teams to intervene early, potentially halting or reversing the impact on the child.
4Rising Mobilisation Rates
Since the programme began in April 2021, the hospital has significantly increased its mobilisation efforts. The percentage of patients on respiratory support undergoing early physical activity rose from 44% in 2021 to 60% in 2024. Before this initiative, the rate of early movement for such patients was likely in the single digits.
5Case Study: Michelle Poh
Twelve-year-old Michelle Poh, who suffered from severe acute respiratory distress syndrome, benefited from the programme while on life-support. Even while undergoing extracorporeal membrane oxygenation, she was encouraged to sit up and move to music. This proactive approach allowed her to be discharged in two months and return to school.
6Case Study: Michelle Ng
Eight-month-old Michelle Ng, born with a rare congenital heart defect called ALCAPA, remains under CICU care. Her parents, Richard Ng and Stephanie Livia Rizal, participate in her daily mobilisation activities. The medical team notes that parental presence significantly reduces the infant's distress, aiding the overall effectiveness of the hospital's recovery plan.
7Multi-Disciplinary Team Effort
The programme relies on a collaborative effort between nurses, physiotherapists, and family members. Techniques include tummy time for infants and using walking frames for older children to prevent muscle shrinkage. By involving parents in the process, the hospital ensures that children receive essential emotional support while performing their prescribed physical exercises.
8Future of Paediatric Care
The success of Let’s MoveEM demonstrates that movement is a critical component of medicine for critically ill children. By reducing the duration of mechanical ventilation and hospital stays, KKH is setting a new standard for paediatric intensive care. The focus remains on preventing long-term physical and cognitive impairments for all young survivors.