Providing Patient Mobilization With a Mobility Technician Improves Staff Efficiency and Constrains Cost in Primary Total Hip Arthroplasty

Mazzei, Christopher; Yurek, John W.; Patel, Jay; Poletick, Eileen; D'Achille, R.; Wittig, James C.

doi:10.1016/j.arth.2020.03.042

Cited by 4 publications

(8 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most important finding of this study is that patients who ambulated with MT assistance experienced increased rates of discharge to home. While prior literature has demonstrated similar findings, the interpretation and generalizability of these results are limited due to the highly specific patient demographics, which included primarily orthopedic surgery patients [ 13 , 15 ], COVID-positive patients [ 16 ], or intensive care unit patients [ 17 ]. This study is one of the few to demonstrate that an early mobilization protocol led by MTs can reproduce these results with a diverse, heterogeneous patient population.…”

Section: Discussionmentioning

confidence: 88%

“…Despite the increased adoption, there is a scarcity of data regarding the impact of MTs on the length of stay; this study demonstrates a reduction in this metric. To date, only two studies have analyzed the impact of MTs on median length of stay, with both showing no significant change [ 13 , 15 ]. However, an important consideration for these contrasting results is their inclusion criteria, which selected for elective orthopedic surgery patients with expected short hospital courses.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Improving Discharge Rates to Home With the Help of Mobility Technicians: A Step in the Right Direction

Patel,

Imburgio,

Johal

et al. 2023

Cureus

View full text Add to dashboard Cite

Background Early ambulation during acute hospitalization has been associated with improved clinical outcomes for patients. Despite the benefits of mobility in the hospital setting, physical therapists and nursing staff are often constrained by time. Mobility technicians (MTs) are individuals with specialized training who have emerged as a potential solution by providing safe ambulation for patients during their hospital stay. Objectives The purpose of this quality improvement project was to investigate the impact of MTs on clinical and financial outcomes for admitted patients at a high-volume tertiary institution. Methods A quality improvement project was implemented at Jersey Shore University Medical Center, Neptune City, from October 2022 to March 2023. The study was a prospective, single-institution cohort study and included patients admitted to two medical floors. Patients were divided into an experimental group that received services from MTs and a control group that did not receive this service but was eligible based on clinical status. The primary endpoint was the proportion of patients discharged to home. Secondary outcomes included the length of stay and financial impact. Results A total of 396 admitted patients were included, with 222 patients in the MT group and 174 in the non-MT group. Patients in the MT group were discharged home more frequently, at a rate of 79.7% compared to 66.1% for patients in the non-MT group (p = 0.002). MTs contributed to an average 2.4-day reduction in the length of hospital stay (7.8 days vs. 10.2 days, p = 0.007). The MT intervention led to an estimated net savings of $148,500 during the six-month study period. Additionally, 2.9 daily hospital beds were created. Conclusion Implementing an MT program significantly increased the discharge-to-home rates and decreased hospital length of stay. Preliminary analysis suggests that this intervention is cost-effective and can assist institutions in managing increased hospital capacity strain through the creation of additional hospital beds.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Improving Discharge Rates to Home With the Help of Mobility Technicians: A Step in the Right Direction

Patel,

Imburgio,

Johal

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…While setting productivity standards is not common for nursing staff, establishing productivity standards for MTs may be helpful in sustaining desired mobility goals and rates. A productivity standard of 12 to 15 patients per 8-hour shift has been suggested for the MT since they do not have the same documentation burden as rehabilitation therapists 32,38. This standard was lacking during this data collection period, but the authors propose that this should be implemented and monitored with the goal of achieving their mobility and determining staffing needs.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, another common barrier involves the staffing models for rehabilitation therapists, which do not permit daily interventions for even the portion of hospitalized patients who receive a rehabilitation consult. [31][32][33] Hospitals have implemented multiple strategies to improve patients' mobility rates at reduced personnel cost. Such strategies include implementation of nursingdriven mobility screens, formation of mobility teams, and the creation of a mobility technician (MT) position, whose primary role is to increase out-of-bed activity and promote ambulation.…”

mentioning

confidence: 99%

“…Nurses often report a lack of skills and confidence related to mobilizing patients safely, fear of the patient falling or injuring self, and the perception that mobility is the responsibility of physical therapy. Finally, another common barrier involves the staffing models for rehabilitation therapists, which do not permit daily interventions for even the portion of hospitalized patients who receive a rehabilitation consult 31-33…”

mentioning

confidence: 99%

See 1 more Smart Citation

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

Wells,

Frampton,

Horn

et al. 2024

Journal of Acute Care Physical Therapy

View full text Add to dashboard Cite

Introduction: 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. Purpose: 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. Methods: 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. Results: 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). Conclusion: 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.

show abstract

Efficacy of proprioceptive training on the recovery of total joint arthroplasty patients: a meta-analysis

Zhang

Deng

2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background Optimal balance control is of paramount importance for function recovery after total joint arthroplasty (TJA). The study objective of this meta-analysis was to assess the short- and mid-term effects of proprioceptive and balance training for patients undergoing TJA. Methods Electronic searches were conducted from PubMed, Cochrane library, and Embase databases to identify eligible RCTs through May 2020. Standard mean difference (SMD) with 95% confidence interval (95%CI) was applied to calculate pooled effect estimates between proprioceptive and balance training and control group. Main outcomes were self-reported functionality, balance, pain, quality of life, and function (range of motion). Results Seven randomized controlled trials were finally included in this meta-analysis. Pooled results found that balance and proprioceptive trainings have a positive role in improving self-reported functionality at short-term after TJA. Moreover, balance and proprioceptive trainings were associated with an increase of the balance at short- and mid-term after TJA. These results were further confirmed by subgroup analysis between preoperative and postoperative administration of balance and proprioceptive trainings. Conclusion Our meta-analysis suggests that balance and proprioceptive trainings after TJA improved self-reported functionality and balance. These improvements were maintained at mid-terms. More research is needed to confirm balance and proprioceptive trainings for pain and quality of life for TJA.

show abstract

Providing Patient Mobilization With a Mobility Technician Improves Staff Efficiency and Constrains Cost in Primary Total Hip Arthroplasty

Cited by 4 publications

References 13 publications

Improving Discharge Rates to Home With the Help of Mobility Technicians: A Step in the Right Direction

Improving Discharge Rates to Home With the Help of Mobility Technicians: A Step in the Right Direction

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

Efficacy of proprioceptive training on the recovery of total joint arthroplasty patients: a meta-analysis

Contact Info

Product

Resources

About