The risks of bed rest and decreased activity during hospitalization are substantial. Immobility is a significant cause for delay of discharge, suboptimal care and can contribute to poor patient outcomes. An interdisciplinary team approach was implemented to change an organization culture on early patient mobility. The program goals were to focus physical and occupational therapy services for patients who would benefit from their skilled expertise, and to develop nursing protocols, physician order sets, expectations, and education to promote movement of all patients according to their needs and abilities.

The authors have no conflicts of interest and no source of funding to declare. ABSTRACTPurpose: The Greenville Early Mobility Scale (GEMS) was developed by physical therapists (PTs) in an attempt to aid acute care nurses with assignment of patients to a level of mobility. The GEMS is based on a series of physical activities and is developed to encourage early mobility and advance activity as tolerated. The purpose of this study was to evaluate the reliability within and between PTs and nurses for rating mobility using the GEMS.Methods: Ten PTs and 10 nurses evaluated a series of videos that demonstrated various levels of mobility. Each rater assigned a value to the patient's mobility as defined by the GEMS. Percent agreement, withingroup, and between-group reliability were established with the videos and between testers. Reliability was quantified using a Cohen's κ with an α level set at 0.05. Results:There was substantial between-group reliability established between PTs and nurses (κ = 0.668; 95% confidence interval, 0.371-.964; P < .05). Conclusions:On the basis of these findings, the GEMS can be used effectively by PTs and nurses for decision making and communication regarding early patient mobilization on a general medical unit in an acute care hospital.