Professor Harvard Medical School Boston, Massachusetts
Immobility and functional decline is often unrecognized because there lacks a systematic approach to monitor patient function in routine hospital care. Interprofessional measurement of function is a critical aspect of promoting patient mobility, identifying patients at greatest risk for harms, and targeting rehabilitation resources to the most appropriate patients. The Activity Mobility Promotion (AMP) program is a multifaceted mobility QI program using implementation science to incorporate functional assessment into daily routine care by nurses and PT/OTs. Hospital-based functional assessments focus on measurement of performance, using the Johns Hopkins Highest Level of Mobility (JH-HLM), and capacity using the AM-PAC short forms. We present psychometrics of these tools as well as outcomes from several QI projects using these functional assessments in routine practice. We show how tools can be used to set daily mobility goals for nurses, minimize unnecessary consultations from PT/OTs, and to identify patients with higher risk of adverse outcomes.
Understand the value of a systematically applied interprofessional measure of patient function for all hospital patients.
Understand the steps required to implement use of a functional measure for all hospital patients into a health system
Articulate uses for functional measurements in the hospital to set daily mobility goals by nurses, identify patients likely to require post-acute care, and target PT/OT to patients with rehabilitation needs