Lack of functional mobility in hospitalized patients results in a substantial loss of lower‐extremity strength and has been associated with increased falls, skin breakdown, and overall worse medical outcomes. Aside from physical therapy consultation in moderate to severe cases of functional decline, most inpatients lack a consistent, integrated, and collaborative approach to their mobilization. In addition, there is often a lack of patient engagement in improving motor strength and function, and there is often an inadequate amount of communication between physicians and nursing in the mobility process.
To increase the functional mobilization of patients on a hospitalist unit by engaging the entire interdisciplinary team.
A multidisciplinary project team consisting of physicians, physical therapists, and nursing staff developed a comprehensive functional mobility assessment that was completed on every admission and evaluated a patient's baseline functional ability. Based on this assessment, an individualized mobility plan for each patient was developed by nursing and implemented by the interdisciplinary team with the goal of increasing the number of functional mobility interventions in a given day. Nursing and unit staff quantified the extent of mobility by estimating the number of feet patients ambulated in a given day, the amount of time spent in the chair, or the frequency of body rotation in bed, whichever was applicable. Whiteboards in patient rooms were used to list mobility goals and track daily progress to engage patients and all caregivers in the mobility plan. The electronic medical record was also used to list daily mobility goals and track the extent of actual mobility, allowing for more transparency. Physicians were involved in the process, with mobility discussions held during daily interdisciplinary rounds. In addition, nurses provided feedback on actual patient activity to allow physicians to more appropriately order physical therapy consults, which led to improved therapy utilization.
A total of 138 patients were enrolled in the mobility pilot encompassing 670 patient‐days. The number of nursing mobility interventions documented doubled during the pilot. In addition, patients were noted to ambulate an average of 93.6 feet compared with 6.9 feet at baseline and were in the chair an average of 66 minutes relative to 12 minutes at baseline (Fig. 1). Thus, the development of an individualized mobility plan with involvement of the entire interdisciplinary team had a significant effect on improving functional mobility. Greater focus should be undertaken to develop future strategies to increase mobilization of inpatients and to measure their effect on outcomes.
H. Shah ‐ none; C. Donaubauer ‐ none; L. Sargant ‐ none; K. Schumacher ‐none; R. Young ‐ none
To cite this abstract:Shah H, Donaubauer C, Sargant L, Schumacher K, Young R. An Innovative Approach to Improving Functional Mobility on a Hospitalist Unit. Abstract published at Hospital Medicine 2011, May 10-13, Dallas, Texas. Abstract 205. Journal of Hospital Medicine. 2011; 6 (suppl 2). https://www.shmabstracts.com/abstract/an-innovative-approach-to-improving-functional-mobility-on-a-hospitalist-unit/. Accessed July 23, 2019.