Mobility Is Medicine, Too: Creating a Culture of Mobility Amongst Hospitalized Patients With Cancer to Improve Patient Outcomes

S. Morjaria, Claire Carmody, Saket Navlakha, Wei Zhou, Donna Braccia, Jennifer Aquino, Adam Roumm, Steve Martin, G. Syrkin
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Abstract

Despite decades of evidence demonstrating the effectiveness of multidisciplinary mobility initiatives in improving patient clinical outcomes, the impact of mobility programs in oncology-specific settings has been ignored. The objective of this initiative is to test evidence-based mobility interventions in a cancer care center to create a culture among clinicians that prioritizes patient mobilization. We compared postintervention and preintervention outcomes using logistic regression analysis and time-to-event modeling to assess hospital length of stay. Basic statistical methods assessed whether improving mobility influenced clinical outcomes and clinician culture. Outcome data from 493 in the postintervention arm were compared to 498 patients in the preintervention arm. Patients in the postintervention group had 39% decreased odds of having the rapid response team called (confidence interval [CI] =0.39–0.97; P = .03) and 46% decreased odds of being admitted to the intensive care unit (CI = 0.29–1.02; P = .05) compared to the preintervention group. No safety issues were associated with these interventions. Hospitalized patients with cancer are especially prone to considerable debility due to their disease and treatment effects. Our initiative to create a mobility protocol in 1 medical unit resulted in positive clinical outcomes. Findings from this study can be used to increase recognition of the benefits of mobility programs for hospitalized cancer patients. Promoting mobility in the hospital often involves collaboration among various healthcare professionals, including nurses, physical therapists, occupational therapists, and physicians. This interdisciplinary approach ensures that patients receive holistic care tailored to their specific needs.
移动也是医学:在癌症住院病人中创建移动文化,改善患者预后
尽管数十年来已有证据证明多学科移动计划在改善患者临床预后方面的有效性,但移动计划在特定肿瘤环境中的影响却一直被忽视。 这项计划的目的是在癌症治疗中心测试以循证医学为基础的移动干预措施,在临床医生中营造一种优先考虑患者移动的文化。 我们使用逻辑回归分析和时间到事件模型对干预后和干预前的结果进行了比较,以评估住院时间。基本统计方法评估了改善移动能力是否会影响临床结果和临床医生文化。 将干预后组 493 名患者的疗效数据与干预前组 498 名患者的疗效数据进行了比较。与干预前相比,干预后组患者被呼叫快速反应小组的几率降低了 39%(置信区间 [CI] =0.39-0.97;P = .03),入住重症监护室的几率降低了 46%(CI = 0.29-1.02;P = .05)。这些干预措施均未涉及安全问题。 由于疾病和治疗效果的影响,住院癌症患者尤其容易出现严重衰弱。我们在一个医疗单位制定的移动方案取得了积极的临床效果。 这项研究的结果可用于提高人们对住院癌症患者移动方案益处的认识。 促进医院内的移动能力通常需要护士、理疗师、职业治疗师和医生等不同医护专业人员之间的合作。这种跨学科的方法可确保患者获得符合其特定需求的整体护理。
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