Abstract
Hospitalization is common among older adults. Prolonged time in bed during hospitalization can lead to deconditioning and functional impairments. Our team is currently working with Department of Veterans Affairs (VA) medical centers across the United States to implement STRIDE (assiSTed eaRly mobIlity for hospitalizeD older vEterans), a hospital-based walking program designed to mitigate the risks of immobility during hospitalization. However, the COVID-19 pandemic made in-person, or face-to-face, walking challenging due to social distancing recommendations and infection control concerns. In response, our team applied principles of implementation science, including stakeholder engagement, prototype development and refinement, and rapid dissemination and feedback, to create STRIDE in Your Room (SiYR). Consisting of self-guided exercises, light exercise equipment (e.g., TheraBands, stress ball, foam blocks, pedometer), the SiYR program provided safe alternative activities when face-to-face walking was not available during the pandemic. We describe the methods used in developing the SiYR program; present feedback from participating sites; and share initial implementation experiences, lessons learned, and future directions.
Highlights
IntroductionMany older adults spend extended periods of time in bed while hospitalized
Older adults are at higher risk for hospitalization compared to their younger peers
The STRIDE program consists of an initial consult followed by a gait assessment early in a patient’s hospitalization and one to two daily walks supervised by a mobility assistant
Summary
Many older adults spend extended periods of time in bed while hospitalized. AssiSTed eaRly mobIlity for hospitalizeD older vEterans (STRIDE) is an evidence-based walking program aimed at increasing hospitalized patients’ mobility through daily, supervised walks during the course of an inpatient hospital stay. The STRIDE program consists of an initial consult (submitted by a physician or nurse) followed by a gait assessment (typically conducted by a physical therapist) early in a patient’s hospitalization and one to two daily walks supervised by a mobility assistant (e.g., recreational therapy or physical therapy assistant). An initial clinical demonstration evaluation of the program found that older adults participating in STRIDE were more likely to spend fewer days in the hospital and be discharged home rather than a skilled nursing facility [3]. Sites are encouraged to adapt staffing models, documentation procedures, and marketing tools to maximize “fit” with the local setting
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