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Comparación de enfoques para apoyar la implementación de un programa de caminata hospitalaria: evidencia de un ensayo
Susan N Hastings1,2,3,4,5, Karen M Stechuchak6, Caitlin B Kappler6
1Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA. susan.hastings@duke.edu.
Journal of general internal medicine
|February 26, 2026
Resumen
El soporte mejorado no mejoró significativamente el programa de movilidad hospitalaria STRIDE
Área de la Ciencia:
- Medicina Geriátrica
- Ciencia de la Implementación Sanitaria
- Mejora de la Calidad en la Atención Sanitaria
Sus antecedentes:
- Los programas de movilidad hospitalaria son cruciales para la recuperación funcional en adultos mayores, alineándose con la atención amigable para la edad.
- Las estrategias óptimas de implementación para programas de movilidad hospitalaria no están bien definidas.
- El programa STRIDE tiene como objetivo mejorar la movilidad de los pacientes hospitalizados de edad avanzada.
Objetivo del estudio:
- Comparar el soporte fundamental frente al soporte mejorado para implementar el programa de movilidad hospitalaria STRIDE.
- Evaluar la efectividad de dos estrategias de implementación distintas en hospitales de Asuntos de Veteranos (VA).
Principales métodos:
- Un ensayo controlado aleatorizado por conglomerados paralelo que involucra a 35 hospitales VA.
- Los hospitales fueron asignados a soporte fundamental (recursos estándar) o soporte mejorado (facilitación personalizada).
- El estudio incluyó hospitalizaciones de medicina general para pacientes de 60 años o más, midiendo la penetración y fidelidad del programa.
Principales resultados:
- No se observaron diferencias significativas en el porcentaje de hospitalizaciones con caminatas STRIDE o métricas de fidelidad entre los brazos de soporte mejorado y fundamental.
- Ambas estrategias de implementación mostraron tasas similares de inicio del programa STRIDE.
- Las barreras y facilitadores de la implementación fueron comparables en ambos brazos de soporte.
Conclusiones:
- El soporte mejorado no demostró una ventaja significativa sobre el soporte fundamental para implementar el programa de movilidad hospitalaria STRIDE.
- Se necesitan estrategias específicas para mejorar el alcance y el impacto de los programas de movilidad hospitalaria.
- Se requiere más investigación para optimizar las iniciativas de atención amigable para la edad en entornos hospitalarios.
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