Mobility program benefits hospitalized patients with cancer
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A mobility program significantly decreased health care utilization among hospitalized patients with cancer, according to study results presented during the ASCO20 Virtual Scientific Program.
The initiative also improved the patient experience, results showed.
“We were pleased to see reductions in excess hospital days and readmission rates and increased patient satisfaction. I was surprised — and elated — to see how well this initiative worked in terms of maintaining or improving mobility function,” researcher Cardinale B. Smith, MD, PhD, chief quality officer for cancer at Mount Sinai Health System and a HemOnc Today Next Gen Innovator, told Healio.
Patients with cancer often require hospitalization due to complications from the disease or their treatment. Many experience declines in physical function, which can result in increased length of stay, additional readmissions, a poorer patient experience and poorer outcomes.
“Therefore, increased activity and mobilization during hospitalization are essential to prevent functional decline,” Smith told Healio. “Whereas previous research has focused on risk factors that limit mobility and interventions for enhancing mobility in well-functioning, community dwelling older adults, there have been limited interventions on the mobility of hospitalized [patients with cancer]. As such, we wanted to pilot a program aimed at mobility to see if we could improve patient outcomes.”
Smith and colleagues implemented a mobility aide program on an oncology unit in a large academic medical center between April 2 and Dec. 31, 2019.
The 988 admitted patients in the program underwent a nursing evaluation in which the Activity Measure for Post-Acute Care — an ordinal scale that ranges from bed rest to ambulating 250 feet or more — quantified their mobility.
A multidisciplinary team that consisted of physical therapy, nursing, a mobility aide and a medical assistant with enhanced rehabilitation training developed care plans for patients, who were mobilized two times daily.
Researchers evaluated the program’s impact on excess days in the hospital, readmissions, changes in mobility and patient experience as assessed by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). They compared outcomes during the study period with the 6-month period prior to program implementation.
Results showed a 6% reduction in excess days (P = .04). The readmission rate declined from 25% prior to program implementation to 19% after (P = .03).
The majority (76%) of patients maintained or improved their mobility scores, and HCAHPS scores — which gauge patients’ willingness to recommend the hospital — increased from 63% at baseline to 91% after program implementation (P = .01).
“This demonstrates that non-physical therapy (PT) professionals can mobilize hospitalized [patients with cancer], decreasing the burden of PT and nursing resources,” Smith told Healio. “The use of mobility aides is feasible and improves important patient outcomes. Future work will evaluate the sustainability of the program and evaluate association with health care costs.” – by Mark Leiser
Reference:
Smith CB, et al. Abstract 7008. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
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Smith CB, et al. Abstract 7008. Presented at: ASCO20 Virtual Scientific Program; May 29-31, 2020.
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