Achieving a Culture of Mobility: Implementation of a Mobility Aide Program to Increase Patient Mobilizations in an Acute Care Hospital

Abstract

Background and Purpose: Mobilization of patients during inpatient hospitalization has been shown to be an important aspect of quality care that reduces risk for a number of complications. It is impractical and cost prohibitive for physical therapists (PTs) alone to provide all mobilization activities to hospitalized patients. Patient mobilization requires an interprofessional approach with all staff prioritizing patient activity. This descriptive research captures the productivity and patient effect of a patient mobilization program within an inpatient unit: Does the implementation of a mobility aide (MA) in an acute care hospital increase overall patient mobilizations? Does the use of an MA alleviate the workload of a PT to allow focus on skilled intervention and decreased frequency of visits? Methods: The MA's primary responsibility was to provide mobility interventions for patients under the direction of the PT in collaboration with nursing staff to improve frequency of mobilization and allow PTs to concentrate on skilled interventions. The PT and MA educated registered nurses and family members on mobility techniques for specific situations and promoted patient mobilization by nursing staff. The MA workload log, physical therapy orders, treatment frequency, and category of professional/caretaker who provided the intervention were recorded for 519 patients after the MA program implementation. This was compared to nursing unit-level, baseline mobilization metrics 1 week prior to MA program implementation. Physical therapist use measured as frequency of visits in the plan of care was compared to an equivalent time period prior to program implementation. Results: Since implementation of the MA program in this acute care hospital, there has been an observed 36% increase in patients walking on the unit as well as a 48% decrease in patients with no mobilizations. Trends in PT encounter frequency and increased PT referrals suggest that the PTs are able to focus on skilled intervention rather than general mobilization. The cost of implementing the MA program has been determined to be offset by a 10% increase in new PT referrals. While daily and twice a day visits by the PT decreased, the frequency of 1 to 3 visits per week increased suggesting increased breadth of PT services. Conclusion: Adding an MA to patients' plan of care may be a cost-effective method to optimize patient mobility in the acute care hospital setting. The addition of an MA to a medical/surgical unit produced positive outcomes in number of patient mobilizations and allowed improved use of the PT.