Evaluation of the implementation of a mobility plan in a geriatric clinic in Switzerland - a quality improvement...

Patient inactivity during hospitalisation is a widespread issue, particularly affecting older adults and contributing to functional decline and prolonged hospital stays. Mobility Plans are a promising strategy to support goal-directed mobilisation, yet their implementation remains challenging. This quality improvement study aimed to evaluate the success of implementing the Mobility Plan in a Swiss geriatric clinic. The secondary objective was to describe inpatient mobility before and during implementation.

A within-site quality improvement design was used, guided by the Implementation of Change Model and the Implementation Research Logic Model. Five implementation outcomes - acceptability, appropriateness, feasibility, fidelity, and adoption - were evaluated through healthcare professional questionnaires and analysis of the Mobility Plan documentation. Inpatient mobility was assessed using step counters in two independent four-week evaluation phases: one before and one during the three-month implementation of the Mobility Plan. Descriptive statistics were applied to all outcomes.

Therapists reported agreement rates above the predefined 50% threshold for all implementation outcomes at the subscale level (acceptability: 68.2%, appropriateness: 90.9%, feasibility: 90.9%), whereas nurses reached the threshold only for appropriateness (56.7%) but not for acceptability (23.3%) or feasibility (45%). No physicians responded to the questionnaire. A total of 69 Mobility Plans were analysed. Fidelity, defined as the proportion of days with a documented mobility objective, reached a median of 75% [IQR 56-86%], while adoption, defined as the proportion of days with at least one recorded mobility activity, reached 88% [IQR 80-92%]. Median daily step counts were descriptively higher on all four measurement days in the second evaluation phase compared with the first.

The implementation of the Mobility Plan showed mixed results. It appeared feasible to apply in daily practice, although engagement varied across healthcare professionals. A small increase in daily steps was observed during the implementation phase, although this cannot be linked directly to the Mobility Plan because of the study design. Further work is needed to strengthen interdisciplinary uptake and to examine its potential effects on patient mobility using more robust study designs.

Clinical trial number: not applicable.