June 2011

Early Mobilization Impacts Function, LOS

Early mobilization of hospitalized older adults can help preserve functional independence and reduce length of stay. These are among the findings of a pilot program sponsored by NCH's Focus on Function team, an interdisciplinary subgroup of the Geriatric Best Practice Team.

The six-month pilot, which took place on the Medical Pulmonary and Medical Renal units (5 and 6 East), yielded positive results, and the Focus on Function team, led by Donna Boyd, RN, geriatric clinical nurse specialist, was recently invited to share their findings at "On the Front Line of Change," the 14th annual conference of NICHE (Nurses Improving Care for Healthsystem Elders). The conference, held in Las Vegas, brought together 450 nurses, nursing administrators, educators and other healthcare professionals from across the U.S. and Canada who are dedicated to improving the quality of care for hospitalized older adults.

"We were thrilled to be invited to present our poster, 'Helping a Patient Home,' at the NICHE conference," says Dina Lipowich, RN, director of Medical Nursing and Inpatient Geriatrics. She explains the goals of the pilot included:

  • Maintaining patients' baseline functional status after hospitalization
  • Increasing the likelihood of discharge to home
  • Improving multidisciplinary communication
  • Engaging staff in embracing a "culture" of early and frequent ambulation
  • Improving performance on patient satisfaction indicators

Strategies to accomplish these goals included the development of a multidisciplinary Mobility Communication Tool (MCT), a form used to document the patient's mobility status pre- and post-hospitalization, along with dates and times of mobility exercises that were performed on the unit. The MCT is now in use on 5 and 6 East. Other strategies include tools for educating patients, family and staff on the benefits of mobility; and collaboration with Infection Prevention & Control in the development of guidelines for safe ambulation of patients in isolation. "Our physical environment is designed to encourage mobility, too," says Lipowich. "The units now have footprint decals spaced strategically, about 10 feet apart, which serve as a great motivator to our patients."

Lipowich says the pilot succeeded in motivating patients to participate in their own recovery, with patients ambulating in the hallways more frequently. Data analysis pre- and post-implementation suggests an increase in the number of patients discharged back to home. In addition, patient satisfaction scores reflect an increase in "likelihood to recommend." "And, in keeping with our Hospital-wide focus, we were successful in decreasing overall length of stay in this population," Lipowich says. She adds that this pilot now serves as a model, with NCH's Department of Clinical Affairs currently assessing its implementation Hospital-wide.

For more information, please contact Dina Lipowich, RN, at 847.618.6510.