Optimizing Rehabilitation Referrals to Improve Early Mobility and Discharge.

Abstract

Background: In a 30-bed medical-surgical unit, only 53% of patients received complete mobility screening versus the 80% national benchmark due to incomplete activity orders and poor communication among providers, nurses, and therapists. Objective: The aim of the study is to enhance mobility management by integrating systematic mobility discussions into daily multidisciplinary rounds and achieving 100% comprehensive mobility screenings. Methods: This 15-week project implemented staff training on the care team rounds flow sheet. Patient mobility was reviewed during daily rounds, with providers completing missing activity orders to enable nursing screenings and rehabilitation referrals. Weekly data were analyzed using Research Electronic Data Capture (REDCap). Results: Among 359 patients, 5.6% (n = 20) lacked activity orders and 7% (n = 24) lacked mobility screenings. During rounds, 100% of patients with missing activity orders received appropriate orders and subsequent screenings. Run-chart analysis showed decreasing trends in missing orders. Conclusions: The intervention achieved 100% compliance in placing missing activity orders and assessing mobility status. Using validated tools within interdisciplinary discussions enhances patient outcomes and hospital efficiency. Implications for Nursing: This approach empowers nurses to conduct comprehensive mobility assessments, improving care coordination and patient safety while establishing clear protocols for mobility management.