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

Although older adults comprise 16%-22% of the population, they account for up to 75% of hospital admissions and nearly half of related costs. Frailty, multimorbidity and reduced physical function are common, requiring assessment and follow-up. Systematic assessment of physical function using the Cumulated Ambulation Score (CAS), 30-second sit-to-stand test (30s-STS), and handgrip strength (HGS) has shown predictive value for outcomes such as length of hospital stay, complications, readmission and survival in hospitalised older patients. This underscores the importance of early intervention in rehabilitation. The successful integration of evidence-based practices necessitates the use of an evidence-based implementation model, such as the Quality Implementation Framework (QIF), which clearly outlines what to address and which actions to take to secure the quality of the implementation process and patient outcomes in the clinical setting.

This study aims to describe and evaluate the implementation process of systematic assessment of physical function in hospitalised medical patients using QIF.

A prospective implementation study, incorporating both quantitative and qualitative methods, was conducted at two medical wards in a Danish hospital. QIF was employed to guide the implementation and the evaluation of the systematic assessment.

Implementation of the systematic assessment showed that early stakeholder engagement and leadership support ensured ownership and staff buy-in. A structured implementation plan clarified roles and accountability. Process evaluation revealed high penetration and acceptability, with improved fidelity over time. Workflow challenges remained, and adoption into daily practice among therapists was limited due to time constraints and documentation burden. Expansion to new departments demonstrated scalability.

A structured QIF-based approach to implementing systematic assessments in hospitalised medical patients proved feasible, acceptable, and potentially scalable. Stakeholder engagement, management support and strengthened cross-sector collaboration were key to success. Sustainability depends on workflow integration, timely data-driven feedback and continued training.