The Mobility Project

Reducing functional decline and loss of mobility for hospitalized patients

Opportunity

Functional decline and loss of mobility for hospitalized patients can increase length of stay (LOS) and heighten the risk of falls and hospital-acquired conditions. Research also suggests that mobility impairment during hospitalization can result in adverse post-discharge outcomes such as increased readmission and long-term care placement rates, and even death. 

The overall impact on society is considerable. At least 50 percent of disability in seniors begins with a functional decline during hospitalization, and nearly 50 percent of total Medicare spending on seniors is attributable to those with a disability.

Intervention

In partnership with clinical teams at Penn Presbyterian Medical Center (PPMC), we piloted early mobility care pathways for moderate and high-risk populations.

The interventions - Get Up & Go and Three East Safari -  leveraged gamification to address mobility barriers. Get Up & Go challenged patients to walk to geography-themed regions to collect tickets. At the same time, Three East Safari engaged patients to find an animal sticker their nurse had hidden for them on the floor, and then, in turn, hide the sticker from their nurse before returning to bed. 

Each of the programs was designed to improve patient and staff understanding of daily goals and encourage and recognize movement by delivering variable rewards based on progress.

Impact

In initial pilots, patients who participated in a mobility game ambulated 80 percent farther than their peers, and 48 percent more patients met their pathway goal for discharge. 

The team plans to build on the promising results of these pilots by conducting a more extensive study of approximately 200 patients to determine if a gamified mobility program significantly increases the rate of discharge to home for lower-extremity joint replacement and open-heart surgery patients. Secondary outcomes include reducing readmissions, reducing length of stay, reducing falls, and improving quality metrics.

Phase 1: It might work
Collaborators

Jennifer Nelson, RN, MSN, CCRN
Staci Pietrafesa, MSN, RN, NE-BC
Heather Greyson, PhD, NP, RN

Innovation leads

Matt Van Der Tuyn, MA
Mike Begley, MA
Catherine Shi, MSN, RN
Maggie Debski
Roy Rosin, MBA

Funding

Innovation Accelerator Program

Innovation Methods

A day in the life

One of the best ways to learn more about a problem area is to experience it yourself. Immerse yourself in the physical environment of your user.

Do the things they are required to do to gain a firsthand experience of the challenges they face. Completing a day in the life exercise will enable you to uncover actionable insights and build empathy for the people you're hoping to help.

A day in the life

Several themes emerged about the barriers to mobility in the hospital setting, including a lack of clear incremental goals, an intangible sense of progress, and a culture of bed rest.

Videos

Pitch Day 2017