Innovative post cardiac surgery technique gets international attention

Staff members at the Foothills Medical Centre were the first in Canada to implement a new standard of care following open heart surgery. “Keep Your Move in the Tube” (KYMITT) was introduced several years ago in the cardiovascular intensive care unit (CVICU) after research conducted by physiotherapist Lauren Park; clinical nurse educators Chris Coltman, Heather Agren and Susan Colwell; and Dr. Kathryn King-Shier, PhD, associate dean of graduate programs for the University of Calgary’s Faculty of Nursing.

The technique is pain-guided and involves keeping elbows tucked into the sides while lifting, pushing, pulling or raising the arms above the head. It helps prevent sternal wound complications and allows patients to return to their normal activities much quicker, which may alleviate patient anxiety and even lower health-care costs.

Follow up research published by the Calgary team has gotten international attention.

A team from the Netherlands of the Medisch Spectrum Twente, including Dr. Frank Halfwerk, MD, and physiotherapists Nicole Wielens, Kim Roerdink and Ankie Olde Keizer, recently visited Calgary to learn more about implementing KYMITT in their own country. 

“We think KYMITT will improve life post surgery, not only in the recovery stage, but also after discharge and weeks later when they start cardiac rehabilitation,” says Halfwerk, who works with cardiac surgeons and is the principal investigator in the Cardiac Surgery Innovations Lab in the Dept. of Biomechanical Engineering at the University of Twente.

According to Halfwerk, the instructions given to patients following open heart surgery are currently restrictive. Patients are told not to push, pull or lift anything more than 10 pounds, raise their hands above their head or use their arms to get out of bed or a chair for several weeks following surgery to allow the sternum to heal.

KYMITT puts more control back into the hands of patients, allowing them to get back to their regular life quicker.

Wielens has been pleasantly surprised by what she has learned during her visit.

“It’s been a surprise how quickly the post surgery care teams mobilize patients,” says Wielens. “The KYMITT technique is amazing and will dramatically improve recovery for patients.”

Keizer says she is impressed with how well the Calgary team communicates with patients.

“This technique is very clearly explained and as a result the patients know what to do,” she says. “This technique is also a lot more positive for patients, rather than being told what they can’t do, they are told what they are able to do. That makes a big difference.”

All four of the visitors were excited with the culture they encountered in Calgary. 

“It’s amazing here,” says Wielens. “Everyone is on the same page here and so enthusiastic. All the health professionals, from physiotherapists and occupational therapists to the cardiac surgery team and leadership, everyone supports this movement.”

Halfwerk agrees.

“What’s amazing about the Calgary team is the commitment to patient care exhibited by the staff,” he says. “They are so eager to improve patient care.”

According to Halfwerk, the team is the first in Europe to implement the KYMITT technique. He thinks it will be very popular. He notes the team is planning a clinical trial in their own country to provide more scientific evidence that KYMITT improves quality of life for patients. 

Coltman and Park were equally happy with the visit.

Park, the CVICU project lead for KYMITT, said the Dutch team visited several locations, shadowing the Calgary team while they worked with patients, meeting with leadership, attending rounds and speaking with nurse educators.

“So much has come out of this visit,” says Park. “The team’s enthusiasm for this work and their passion for patient care came across strongly.”

The visit has encouraged the Calgary team in their aspiration to spread the KYMITT movement.

“Our aspiration is to take this further,” says Park. “It would be great to see KYMITT introduced as a national guideline because it is so valuable for patients.”