Mobility of hospitalised patients (FS-17)

Focused symposium
Sunday 12 May 2019, 16:00-17:30
Room A

Veenhof C1,2Mudge A3Friedman M4Dolan B5,6 
1University Medical Center Utrecht, Physical Therapy Science, Utrecht, Netherlands, 2University of Applied Sciences Utrecht, Innovation of Mmobility Care, Utrecht, Netherlands, 3Royal Brisbane and Women's Hospital, Internal Medicine and Aged Care, Herston (Queensland), Australia, 4John Hopkins Hospital, Physical Medicine and Rehabilitation, Baltimore (Maryland), United States, 5Health Service 360, Stratford upon Avon, United Kingdom

Learning objective 1: Create awareness of the problem of poor mobility of inpatients and common patient and staff barriers
Learning objective 2: Show practical and evidence based solutions for improving physical activity of inpatients
Learning objective 3: Demonstrate practical examples of implementation in a clinical setting

Introduction of the problem of low mobility in the hospitals by the chair Cindy Veenhof. 
Presentations by recognised experts

  • Chloe Harris will introduce the problem of low mobility in the hospitals and will talk about his initiative #endPJparalysis which is based on evidence that suggests that people mobilise less when in pyjamas and more when fully dressed, which ultimately helps reduce deconditioning.
  • Cindy Veenhof will give detailed description of physical behaviour of inpatients based on scientific literature and based on detailed measurements performed at the University Medical Centre Utrecht using the behavioural mapping method. This presentation will furthermore highlight their approach aiming on 3 topics: the caregivers, the patients, and the physical environment to improve physical behaviour of inpatients.
  • Alison Mudge will present the diagnostic and iterative quality improvement steps they have taken using an implementation science framework to design and implement the Eat Walk Engage program to reduce delirium and enhance functional recovery in older inpatients.
  • Michael Friedman will present the John Hopkins Medicine Activity and Mobility Promotion (AMP) program. AMP firmly establishes the concept that a structured quality improvement approach integrated within existing clinician workflows is beneficial in combating the harms of immobility in the hospital, including length of stay and hospital readmissions.

A 15 minute question and answer session with the audience
A 10 minute summary by the chair highlighting the implications, applicability and relevant messages to take away.
Implications / Conclusions: Deconditioning and functional decline after hospitalisation is an adverse event which can be prevented. By increasing the awareness of this issue at the world conference for physiotherapists and by presenting the audience concrete solutions, the presenters hope to that physiotherapist all over the world will take action in their own acute or subacute setting to start changing the immobilising culture. 
Key-words: 1. physical behaviour 2. hospital 3. implementation
Funding acknowledgements: nothing to declare
Relevance to physical therapy globally: Yearly, 4.5 billion people are admitted to a hospital in Europe alone. Hospitalisation is the major cause of acquired disability in older patients, in part due to the immobilising culture of hospitals. De-conditioning and functional decline are common and can persist for months after the hospital stay. Physiotherapists need to team with other health professionals, consumers and hospital managers to directly address the physical and cultural barriers to poor mobility in hospital.
Target audience: Physiotherapists, allied health care professionals, clinicians, managers, educators, researchers and policy working in hospitals or working with acute care patients.