Implementing an Activity and Mobility Promotion Approach to Improve Patient Mobility

Area of Science:

• Healthcare quality improvement
• Patient mobility research
• Implementation science in healthcare

Background:

• Hospitalized patients frequently experience reduced mobility, leading to adverse outcomes, particularly in older adults.
• Low patient mobility is associated with functional decline and increased healthcare costs.
• Effective strategies are needed to promote mobility during hospital stays.

Purpose of the Study:

• To implement and assess the feasibility of the Johns Hopkins Activity and Mobility Promotion (JH-AMP) program.
• To examine the preliminary impact of the JH-AMP program on patient mobility in a safety-net hospital.
• To improve patient outcomes and reduce healthcare costs through enhanced mobility.

Main Methods:

• A pre- and postimplementation study design was employed across medical, surgical, and ICU units.
• The JH-AMP program utilized eight strategies based on the Translating Research into Practice framework, setting daily mobility goals for all patients.
• Mobility measures, including the AM-PAC "6-Clicks" Short Form and JH-HLM scale, were integrated into the EHR.

Main Results:

• A significant increase in patients achieving a Johns Hopkins Highest Level of Mobility (JH-HLM) score of 4 or higher was observed postimplementation (P = 0.043).
• There was a significant decrease in the proportion of patients scoring 1 (lying in bed) on the JH-HLM scale across all units (P = 0.031).
• The program demonstrated feasibility for large-scale, systematic hospital-wide implementation.

Conclusions:

• Systematic, hospital-wide implementation of an activity and mobility promotion program is feasible.
• The JH-AMP program can significantly reduce immobility in hospitalized patients.
• Promoting patient mobility is crucial for improving outcomes and reducing associated costs.