The Impact of Mobility Technicians on Mobility Rates for Hospitalized Adults in a Large Academic Medical Center

Abstract

Promotion of early mobility is part of an ongoing effort to mitigate the iatrogenic effects of hospitalization. To assist with mobilization efforts, nursing departments hire mobility technicians (MTs). However, little is known about whether hospital units that hire MTs have increased rates of patient mobilization. The aim of this retrospective study was to determine whether units in an academic medical setting that hired an MT had greater improvements in mobility compared with similar units that did not hire an MT. Two levels of care-matched pairs of hospital units were used for this analysis. Within each pairing, one unit hired an MT. We captured activity days, defined as any documented out-of-bed activity in a 24-hour period, from standardized documentation. A monthly activity rate was calculated for each unit as the average daily percentage of patients who had out-of-bed orders. A difference-in-difference generalized linear model with a time-by-MT interaction, weighted for patient volume, was used to compare the relative improvement in mobility 6 months prior (baseline) to the hiring of an MT to periods 3 and 6 months post-hire. There was a 2.3% absolute increase in activity rate from preperiod to the 3-month postperiod for units that hired an MT, as compared with a 5.1% decline in similar units that did not have an MT. This 8.4% difference in activity rates was statistically significant (P = .03). Over 6 months, the effects of the program waned. Control units continued to decline with a 7.1% drop from baseline) compared with a marginal 0.1% increase in activity rates for units with an MT from baseline. This relative 7.6% increase in mobility was not significant (P = .13). There was a significant improvement in activity rates associated with MT hire that declined over time. These results may be contributed to a nonstructured MT utilization, variability with nursing education on the role of the MT, and staffing challenges that diverted the use of the MT to nonmobility activities.