Using Systematic Functional Measurements in the Acute Hospital Setting to Combat the Immobility Harm

Daniel Young; Sapna R Kudchadkar; Michael Friedman; Annette Lavezza; Sowmya Kumble; Kelly Daley; Eleni Flanagan; Erik Hoyer

doi:10.1016/j.apmr.2020.10.142

Using Systematic Functional Measurements in the Acute Hospital Setting to Combat the Immobility Harm

Arch Phys Med Rehabil. 2022 May;103(5S):S162-S167. doi: 10.1016/j.apmr.2020.10.142. Epub 2020 Dec 26.

Authors

Daniel Young¹, Sapna R Kudchadkar², Michael Friedman³, Annette Lavezza³, Sowmya Kumble³, Kelly Daley³, Eleni Flanagan⁴, Erik Hoyer⁵

Affiliations

¹ Department of Physical Therapy, University of Nevada, Las Vegas, Nevada; Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland. Electronic address: daniel.young@unlv.edu.
² Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland; Division of Pediatric Anesthesiology and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland.
³ Department of Physical Medicine and Rehabilitation, Johns Hopkins Hospital, Baltimore, Maryland.
⁴ Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
⁵ Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland.

PMID: 33373600
DOI: 10.1016/j.apmr.2020.10.142

Abstract

Hospitalized patients often experience unnecessary immobility and inactivity leading to direct harms and poor outcomes. Despite growing evidence that early and regular mobility and activity are safe and helpful for patients in the hospital, there remains substantial room for improvement in clinical practice. Key to improvement is establishing an interdisciplinary approach to measurement and communication using a common language of function. Here we provide a framework for systematic functional measurement in the hospital. We also provide 3 specific examples of how this framework has been used to improve care: (1) targeting specialized rehabilitation providers to the patients most likely to need their services, (2) generating a daily mobility goal for all patients, and (3) identifying patients early who are likely to require postacute care.

Keywords: Bed rest; Rehabilitation.

MeSH terms

Communication
Hospitals*
Humans
Subacute Care*