Implementation of a Systematic Patient Mobility Program Across 5 Hospitals

The objective of this paper was to evaluate the implementation feasibility of the Johns Hopkins Activity and Mobility Promotion (JH-AMP) framework across geographically diverse hospitals and to examine the association between daily mobility goal achievement and discharge home.

This was a prospective, multicenter, type 3 hybrid implementation study of the hospital mobility promotion program JH-AMP built from the translating research into practice model. The intervention included implementation manuals, e-learning modules, and virtual mentoring.

Participants included 5 US academic and community hospitals involving 15,107 unique patient admissions on participating medical and surgical units.

Primary outcomes were implementation fidelity, measured via documentation compliance (daily Activity Measure for Post-Acute Care Inpatient Mobility 6-clicks Short Form and Johns Hopkins Highest Level of Mobility scores) and mobility goal achievement (observed mobility meeting individualized targets). Multivariable logistic regression estimated the association between consistent goal attainment and discharge home for 7119 analyzable patients.

Documentation compliance ranged from 30% to 98% for Activity Measure for Post-Acute Care Inpatient Mobility 6-clicks Short Form and 53% to 92% for Johns Hopkins Highest Level of Mobility. Daily mobility goal achievement varied by site from 42% to 80%. Each 1 percentage point increase in goal achievement days raised the odds of discharge home by 1% (OR, 1.01; 95% CI, 1.006-1.012; P < .001). Achieving goals on 80% vs 20% of hospital days was associated with a 10.4 percentage point higher probability of home discharge.

Implementing a systematic mobility program is feasible across diverse hospital environments without hiring additional staff. Consistent daily goal attainment is a significant predictor of functional recovery and discharge home, particularly for lower-functioning patients. Policy and practice should prioritize embedding standardized mobility measurement into routine nursing workflows to reduce reliance on post-acute care and improve patient-centered outcomes.