Adherence of Early Mobilization in Post-surgical Patients to Decrease Length of Stay

Abstract

Problem: A 30-bed medical surgical unit has an average length of stay of 5 days on post-surgical colorectal surgeries. The unit serves adults 18 years and older during pre- and post-surgical care. An interview with the unit manager revealed that the unit struggles with postoperative mobility; consequently, patients take longer than expected to recover. Literature evidence supports that early mobilization is beneficial in improving functional capacity, preventing postoperative complications, accelerating the recovery process, and decreasing hospital length of stay (LOS). Purpose: This Quality improvement (QI) initiative is to implement the Activity Measure for Post-Acute Care (AM-PAC) inpatient tool from Johns Hopkins Highest Level of Mobility (JH-HLM) scale to increase early mobilization in post-surgical colorectal patients, so that LOS is less than 4 days, avoiding post-surgical complications. Methods: The tool was implemented during16-weeks in the Fall of 2023. Fifty-six (56) staff members, including registered nurses and patient care technicians were educated regarding the importance of mobilizing patients within 12 hours of arriving at the unit and the timely documentation on the AMPAC inpatient JH-HLM tool before implementation. Unit champions routinely communicated with the staff to remind them of the initiative as well as reinforce education. The QI-Project Lead (QI-PL) provided weekly progress updates to the unit manager and Clinical Site Representative (CSR). Results: During the 17 weeks period there was 100% (n=17) adherence to ambulation of patients within 12 hours of arriving on the unit. A total of 6 patients (n=6) were discharged from the hospital within 2 days (35%), and 11 patients (n=11) were discharged from the hospital within 3 days (65%). Early mobilization of patients resulted in a significant reduction in hospital length of stay with the mean average length of stay of 3 days as compared to 5 days prior to the intervention. Conclusion: Project findings underscore the potential benefits of incorporating early mobility protocols into patient care. Early Adherence of Early Mobilization in Post-surgical Patients 3 mobilization of patients resulted in a significant reduction in hospital length of stay, suggesting a correlation between early mobility and expedited recovery.