A randomized trial of a behavioral intervention to decrease hospital length of stay by decreasing bedrest

Area of Science:

• Clinical Medicine
• Hospital Management
• Patient Outcomes

Background:

• Hospitalized patients frequently experience functional decline due to prolonged bed rest.
• Early mobilization strategies can improve outcomes but are often resource-intensive.
• A pragmatic mobilization protocol was developed to reduce inpatient bed time.

Purpose of the Study:

• To decrease the time hospital inpatients spend in bed.
• To evaluate the effectiveness of a behavioral intervention and recliner chairs in reducing bed rest.

Main Methods:

• A prospective, non-blinded, controlled clinical trial was conducted in an urban teaching hospital.
• Inpatients received either a behavioral intervention (educational handouts) alone or in combination with recliner chairs.
• Primary outcome was hospital length of stay; secondary outcome was functional status using the '6-Clicks' score.

Main Results:

• A total of 6082 patient encounters were analyzed over a 6-month period.
• Neither the behavioral intervention nor recliner chairs significantly decreased length of stay or improved functional status.
• Median length of stay was 84 hours (control), 80 hours (behavioral), and 88 hours (behavioral + recliner).

Conclusions:

• Educational handouts and recliner chairs did not effectively reduce bed rest, improve functional status, or shorten length of stay.
• Active interventions beyond education and physical resources are necessary to mitigate functional decline in inpatients.
• Further research is needed to identify effective strategies for reducing inpatient bed time and its consequences.