Site Manager - Therapy Services Penn Medicine Rehabilitation - Good Shepherd Penn Partners, United States
Research Objectives: To increase number and how often patients are mobilized outside of therapy times.
Design: We used a qualitative approach where we analyzed the data from past years and introduced an intervention to measure and track the results.
Setting: Hospital setting of long term acute care hospital.
Participants: All patients admitted to long term acute care hospital are enrolled in the initiative since it began in 2019.
Interventions: Upon admission to the LTACH, the patient’s mobility level is identified via interdisciplinary communication. This includes, but is not limited to, nursing assessments, therapy notes from hospital transferred from, and verbal team communication. From the above assessments, patients are appropriately placed in corresponding mobility level (Level 1, 2, 3, or 4) which is communicated via schedules and whiteboards in patient room. The patient’s mobility level is reviewed daily via communication between nursing, respiratory, and therapy and upgraded accordingly. Nursing staff documents per shift if patients were out of bed and for how long to improve communication to team members. Lastly, real time feedback and education continue to be provided to staff. This includes but is not limited to “e-thank yous”, review in huddles, and report in daily and discharge rounds.
Main Outcome Measures: Percentage of patients out of bed outside of therapy times Patient satisfaction via LTRAX Pressure injuries
Results: Baseline less than 25% of patients mobilized outside of therapy. Since initiative, 40-70% patients mobilized outside of therapy times. Consistently scoring high on patient satisfaction with top box score at or near 100% over past few years. Prior to initiative, willingness to recommend around 85%. Decrease in worsening and new pressure injuries.
Conclusions: Use of collaborative effort, education, and multiple forms of communication help increase awareness of which patients are appropriate to be mobilized more and how to do so safely. Patients who are enrolled and participate have an improved sense that they were “more productive” during the days, maintain their mobility, and demonstrate this carryover to their therapy sessions during the week.
Author(s) Disclosures: None
Learning Objectives:
Identify interventions to implement mobilization initiative in their facilities.
Identify algorithm to determine patient's appropriate mobility level.
Adapt strategies learned for implementation at their facility.
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