Cardiothoracic surgery (CTS) patients require highly coordinated care by numerous services in the intensive care unit (ICU) after surgery. Complications in this time period increase morbidity, are costly, and significantly increase time spent in the ICU. We set out to shorten the time between cardiothoracic surgery and the patient ambulating with physical therapy as a marker for appropriate patient progress. Delays in time to ambulation after surgery reflect both patient complications and systems issues preventing progression. Our goal was to improve the percentage of patients ambulating on postoperative day one from 60% to greater than 70%.