Implementing Systematic Assessment of Physical Function in Hospitalised Medical Patients: Description and Evaluation...

Area of Science:

• Geriatric Medicine
• Healthcare Implementation Science
• Rehabilitation Medicine

Background:

• Older adults represent a significant burden on healthcare systems, necessitating effective assessment and intervention strategies.
• Frailty and reduced physical function are prevalent in hospitalized older patients, impacting outcomes like length of stay and readmission rates.
• Systematic physical function assessments (e.g., CAS, 30s-STS, HGS) predict patient outcomes, highlighting the need for early rehabilitation interventions.

Purpose of the Study:

• To describe and evaluate the implementation process of systematic physical function assessment in hospitalized medical patients.
• To assess the feasibility, acceptability, and scalability of using the Quality Implementation Framework (QIF) for this implementation.

Main Methods:

• A prospective implementation study utilizing mixed quantitative and qualitative methods.
• The study was conducted across two medical wards in a Danish hospital.
• The Quality Implementation Framework (QIF) guided the implementation and evaluation process.

Main Results:

• Early stakeholder engagement and leadership support fostered staff buy-in and ownership.
• The implementation plan clarified roles, leading to high process penetration and acceptability with improved fidelity.
• Workflow integration challenges, including time constraints and documentation burden, limited therapist adoption, though scalability was demonstrated.

Conclusions:

• A structured, QIF-based approach is feasible, acceptable, and scalable for implementing systematic physical function assessments in hospitalized medical patients.
• Key success factors included stakeholder engagement, management support, and cross-sector collaboration.
• Sustainability hinges on integrating assessments into workflows, providing data feedback, and ongoing training.