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Recommended Citation
Oechler C, Alcaide E. Inpatient Mobility Challenge: Changing Nursing Care Delivery Using Standard Inpatient Mobility Practices to Impact Length of Stay and Discharge Disposition.. Quality Improvement podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Presentation Notes
Quality Improvement podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.
Abstract
Background
Studies have investigated the effects of inpatient mobility practices on hospital length of stay and patient outcomes. Research indicates that implementing dedicated technicians and early mobility programs enhances patients’ physical function, thereby reducing hospital stays.
Local Problem
A non-profit Midwest hospital noted an increased length of stay and higher discharge rates to skilled nursing facilities among geriatric patients. This coincided with participation in the Age Friendly Framework focusing on Mentation, Medications, What Matters, and Mobility (4M’s).
Method
An interdisciplinary Mobility Team was established and a Plan, Do, Study, Act cycle was initiated. Initial barriers included nurses' hesitancy to mobilize patients before physical therapy evaluations and a lack of familiarity with the Comprehensive Mobility Evaluation Tool (CMET). This led to the creation of a nursing competency with return demonstration. Further efforts improved compliance with documenting walking distances and mobility documentation accuracy. Custom distance guides and mobility standards were developed. To enhance practice adoption, a mobility competition was initiated.
Results/Conclusions
Completion of the CMET remained steady (80%), with improvements in accuracy. The percentage of patients getting out of bed rose (baseline 50.3% to 66.3%), and average ambulation distances increased (170 to 1,058 feet). Mobility competitions significantly reduced the average time to first mobility event (12.1 to 5.89 hours). The average length of stay dropped from 4.8 to 4.1 days translating into monthly savings of approximately $807,000 (based on an inpatient cost of $3,167 per day). The Home First Program saw an increase in patients discharged to home or home with care (64.7% to 69.2%).
Implications for Practice:
Implementing structured mobility practices effectively reduced hospital stays and increased home discharge rates for geriatric patients. This approach offers a model for other hospitals striving to enhance patient outcomes and reduce costs, particularly in settings with significant elderly populations.
Document Type
Oral/Podium Presentation
Publication Date
11-13-2024
Inpatient Mobility Challenge: Changing Nursing Care Delivery Using Standard Inpatient Mobility Practices to Impact Length of Stay and Discharge Disposition
Background
Studies have investigated the effects of inpatient mobility practices on hospital length of stay and patient outcomes. Research indicates that implementing dedicated technicians and early mobility programs enhances patients’ physical function, thereby reducing hospital stays.
Local Problem
A non-profit Midwest hospital noted an increased length of stay and higher discharge rates to skilled nursing facilities among geriatric patients. This coincided with participation in the Age Friendly Framework focusing on Mentation, Medications, What Matters, and Mobility (4M’s).
Method
An interdisciplinary Mobility Team was established and a Plan, Do, Study, Act cycle was initiated. Initial barriers included nurses' hesitancy to mobilize patients before physical therapy evaluations and a lack of familiarity with the Comprehensive Mobility Evaluation Tool (CMET). This led to the creation of a nursing competency with return demonstration. Further efforts improved compliance with documenting walking distances and mobility documentation accuracy. Custom distance guides and mobility standards were developed. To enhance practice adoption, a mobility competition was initiated.
Results/Conclusions
Completion of the CMET remained steady (80%), with improvements in accuracy. The percentage of patients getting out of bed rose (baseline 50.3% to 66.3%), and average ambulation distances increased (170 to 1,058 feet). Mobility competitions significantly reduced the average time to first mobility event (12.1 to 5.89 hours). The average length of stay dropped from 4.8 to 4.1 days translating into monthly savings of approximately $807,000 (based on an inpatient cost of $3,167 per day). The Home First Program saw an increase in patients discharged to home or home with care (64.7% to 69.2%).
Implications for Practice:
Implementing structured mobility practices effectively reduced hospital stays and increased home discharge rates for geriatric patients. This approach offers a model for other hospitals striving to enhance patient outcomes and reduce costs, particularly in settings with significant elderly populations.