The Mobility Project
Jennifer Nelson, RN, MSN, CCRN
Staci Pietrafesa, MSN, RN, NE-BC
Heather Greyson, PhD, NP, RN
Ryan Greyson, MD, MHS
Innovation Accelerator Program
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.
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.
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 hopes to build on the promising results of these pilots by conducting a more extensive study 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.