Relationship Between Mobility and Falls in the Hospital Setting

Patients spend an inordinate amount of time in bed during acute care hospitalization leading to immobility harms and poor outcomes. Research has shown that structured mobility programs can decrease functional decline and hospital acquired conditions. Patient falls have financial consequences for hospitals along with potentially severe consequences to the patient. Analysis of this quality improvement project data aimed to determine the relationship between patient mobility levels and quantity of hospital falls.

Our quality improvement team tracked the average Johns Hopkins Highest Level of Mobility (JH-HLM) scores along with hospital fall occurrences during a set time period (2021-2022). We additionally highlighted our lived experiences regarding the relationship to mobility and falls in a typical hospitalized patient and patient outcomes. This provided examples of where the deconditioned patient improved with increased mobility and activity, as well as when the converse occurred.

28,075 patients discharged from a 247-bed acute care hospital from January 2021 to March 2022 were included in the sample. During this timeframe, falls were more likely to occur as patients became deconditioned and immobilized during hospitalization. Increased mobility did not lead to increased risk of falls and a clear inverse relationship was demonstrated between mobility levels and falls.

The growing body of evidence that links falls and immobility supports the continuation of inpatient mobility promotion quality improvement initiatives. We found frequent patient mobilization helped to prevent these harms.