Insufficient mobility contributes to functional decline in hospitalized cardiac patients. Early mobilization programs were shown to improve functional status, increase the likelihood of home discharges, and reduce the length of stay \[1\]. Therefore, there is a need to adapt and implement early mobilization programs in Quebec hospitals. The overall goal of this study is to adapt and implement an early mobilization program in the Cardiovascular units of the Jewish General Hospital (JGH).
All healthcare professionals working in the cardiovascular unit at the Jewish General Hospital.
All patients admitted to the cardiovascular unit at the Jewish General Hospital.
Patients who don't speak English or French.
Sequential
Applying the Early Mobilization Program
BehavioralA mobilization intervention based on the level of function (LOF) ( i.e. patients should be assessed for mobilization status within 24 hours of admission; mobilization should occur at least three times a day, and mobility should be progressive and scaled, tailored to the patient's abilities); The frequency of patient mobilization (primary outcome) will be assessed 20 weeks before implementation, during the 20 weeks of implementation and 20 weeks after the end of implementation (60 weeks in total).
Number of implementation strategies developed to overcome the identified individual and organizational barriers and leverage the facilitators to implement an early mobilization program in this hospital setting.
Investigators will develop strategies to overcome identified barriers and leverage the facilitators to implement the early mobilization program using data obtained from a mixed methods repeated measures design, including: A) Shadowing: an observational grid will be developed, including frequency of mobilization, length of mobilization activity, Health care professionals (HCPs) performing mobilization intervention, type of mobilization intervention, patient and caregiver acceptance and reaction, environmental barriers, available equipment, communication strategies among HCPs, reporting of mobilization interventions in the medical charts, clinicians' comment and observers' impressions and thoughts. B) HCPs will be invited to respond to a survey and participate in a focus group to assess perceived barriers and facilitators to early mobilization. C) Patients and caregivers will participate in a focus group to better understand barriers and facilitators to early mobilization.
Number of patients mobilized divided by the total number of admitted patients during the evaluation period.
Reach of the early mobilization program among patients will be measured with the following indicator: the number of patients mobilized (defined as the patient not being in bed during direct observation) divided by the total number of admitted patients during the evaluation period.
Number of Patients refused being mobilized compared to number of admited patients during the evaluation period.
Acceptability of the early mobilization program among patients will be measured with the refusal rate of being mobilized using the site's administrative data and a file audit that will include a form developed for this purpose.
Number of days between admission and the development of a mobilization plan, between admission and first mobilization and number of patients with at least 3 mobilizations per day per week.
Fidelity of intervention among HCPs will be measured with the following indicators: * Number of days between admission and the development of a mobilization plan * Number of days between admission and first mobilization * Number of patients with at least 3 mobilizations per day per week.
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Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal
Lead sponsor
Jewish General Hospital
Collaborator
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