Hotwire | Monitoring Patient Mobility: Good Medicine, Smart Finances - Hotwire

by Barrett Larson, via Leaf Healthcare

Monitoring Patient Mobility: Good Medicine, Smart Finances

For the first time, new technology enables hospitals to save billions in unreimbursed healthcare dollars by preventing immobility-related conditions

Not long ago, bed rest was considered therapeutic. However, over the past two decades, studies have repeatedly shown that bedrest provides limited therapeutic value and – in fact – it endangers patients.

In 1999, a large meta-analysis involving 39 randomised controlled trials and 5,777 patients found that bed rest was not beneficial as a therapeutic intervention for any condition. The following year, Evidenced Based Nursing published a study that showed early mobilisation was significantly better for patients than bed rest. Since then, numerous studies have reaffirmed the benefits of early and progressive patient mobility.

Today, everyone understands early mobility should be part of virtually every patient’s treatment plan. Most hospitals have adopted patient mobility protocols to encourage patient movement. That being said, the average institution simply cannot fully embrace patient mobility for one reason: it is virtually impossible to effectively monitor and manage patient mobility protocols. Despite healthcare’s push to leverage the power of technology, patient mobility is still monitored in an old-fashioned manner – we use outdated, inefficient, and unreliable techniques.  Given the clinical implications of patient mobility, we need more effective tools to manage this important metric. 

Financial Implications: Cost Savings

In addition to the direct clinical benefits, improving patient mobility also benefits the hospital’s bottom line. When patients are mobilized to a therapeutic level during their hospitalization,  they can often trim a day or two off their length of stay. Automatic monitoring and documentation of patients meeting their prescribed mobility goals helps to discharge at the earliest possible time with the lowest risk of readmission.  Reducing length of stay reduces real hospitalisation costs and lowers the risk of exposure to nosocomial complications (i.e. C-Diff, pneumonia, etc.).

Studies have found that:

  • In patients with community-acquired pneumonia (CAP), improved mobility during their hospitalisation can significantly decrease their length of stay. In these patients, even small decreases in length of stay can reduce hospitalisation costs up to $846 per episode of CAP, which equates to $500 million – $900 million in annual cost savings across the US.
  • Rapid mobilization of total joint replacement patients can be accomplished safely and reduces the overall length of hospital stay in more than 70 percent of patients.
  • Encouraging early mobility in patients recovering from primary total hip arthro­plasties—combined with other adjustments in perioperative care to intensify the team approach—can “effectively cut hospital LOS in half across all surgical areas without causing an associated increase in readmissions. Given the reimbursement pressures by the Affordable Care Act and Accountable Care Act and Accountable Care Organizations to reduce cost, optimize quality and minimize risk, we have demonstrated a safe reduction in hospital stay associated with incre­mental perioperative protocol improvements.”

The findings have encouraged a growing consensus around the value of improving patient mobility. However, the clinical and financial benefits can only be maximized when using appro­priate goals, reliable monitoring methods, and strategic plans to promote patient mobility. Equally important is the broader use of “reliable and valid instruments [that can isolate] the effects of mobility interventions, and such mechanisms are lacking,” wrote Dr. Ji Yeon Choi and her colleagues in a recent study.

The bottom line is that it’s difficult to effectively manage mobility protocols without reliable instru­ments to monitor patient mobility. Fortunately, there are now tools that allow clinicians to ensure that patients are receiving a healthy dose of mobility during their hospitalization. 

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