Loading...
Thumbnail Image
Item

Optimizing Rehabilitation Referrals to Improve Early Mobility and Discharge

London, Dianne
Date
2025-05
Embargo until
Language
Book title
Journal
Publisher
Peer Reviewed
Type
DNP Project
Research Area
Jurisdiction
Other Titles
EARLY MOBILITY
See at
Abstract

Problem and Purpose: In a 30-bed medical-surgical unit at a large suburban hospital, only 53% of patients received a complete mobility screen during their stay, falling short of the national benchmark of 80%. This issue, identified through stakeholder assessment, stemmed from incomplete or missing activity orders and insufficient communication among providers, nurses, and therapists regarding patients’ mobilization status. A retrospective chart review conducted in 2024 revealed the need for process improvements to enhance patient mobility management. This quality improvement project sought to enhance mobility management by integrating systematic mobility status discussions into daily multidisciplinary rounds, ensuring prompt activity orders and rehabilitation referrals for all medically stable adult patients, and achieving comprehensive mobility screenings for 100% of eligible patients. Methods: The project was implemented over 15 weeks in the Fall of 2024, with staff training on using the Care Team Rounds (CTR) Flowsheet done in week one. Patient mobility was reviewed during daily rounds using the CTR Flowsheet, with providers completing activity orders for those who lacked them, allowing nursing staff to conduct screenings and initiate appropriate mobilization and rehabilitation referrals. Following implementation, the project lead collected weekly data and entered it into REDCap, a secure data collection application, for analysis. Results: Throughout the 15-week implementation period, it was noted that 5.6% (n = 20) of the 359 admitted or transferred patients lacked activity orders, and 7% (n = 24) lacked mobility screenings. During the multidisciplinary rounds, 100% of patients (n = 20) with missing activity orders had the appropriate activity orders placed and subsequent mobility screenings completed. Run-chart analysis revealed a decreasing trend in missing activity orders over the 15-week implementation period, although week-to-week variability was observed. Conclusion: Overall, the data suggested positive outcomes, with 100% compliance in placing missing activity orders during multidisciplinary rounds and assessing mobility status for new admissions. These results suggested that utilizing a validated, objective tool to assess mobility in conjunction with an interdisciplinary team during daily standardized discussions can enhance patient outcomes and hospital efficiency, leading to timely mobilization and more comprehensive care planning.

Data Availibility
Data / Code Location
Table of Contents
Description
Series/Report No.
Sponsors
Rights/Terms
Citation
Identifier to cite or link to this item
Scopus Identifier
Embedded videos
Accessibility Note
For accessibility assistance with this record, please contact ArchiveHelp@hshsl.umaryland.edu