Activity Monitor Feedback and Interactive Tours to Improve Postoperative Ambulation

Study Overview
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Brief Summary
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This is a randomized controlled trial that compares a system using activity monitors to provide real-time feedback on daily ambulation to patients undergoing major surgeries, paired with step-count-measured art tours of the surgical units, versus standard of care, on step count. The hypothesis is that the feedback system + art tours will encourage patients to ambulate more.

Detailed Description
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After major surgery, patients are encouraged to walk early and often, since early ambulation is linked with improved clinical and efficiency outcomes. This research study tests whether providing goal-directed feedback on daily ambulation to patients using activity monitors in combination with an app that provides step count-rated art tours of the surgical floors will increase the amount of steps taken after surgery. Upon enrollment, all patients will be assigned to either the control (no intervention) or experimental (activity monitor feedback + art tours) group, stratified by surgery type. This randomized controlled trial aims to determine if this feedback system/art tours approach improves: (1) daily step count, (2) length of stay, and (3) patient satisfaction compared with standard of care.

Official Title
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Randomized Controlled Trial of Activity Monitor Feedback and Interactive Ambulation Tours to Improve Postoperative Ambulation and Efficiency Outcomes After Major Surgery

Conditions
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Surgery

Intervention / Treatment
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* Other: Activity monitor feedback loop


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Undergoing one of the 14 surgeries: Gynecological (Total Abdominal Hysterectomy, Gyn Ex Lap); Orthopedic (Total Hip Replacement, Total Knee Replacement); Minimally Invasive Surgery (Hiatal Hernia Repair/Fundoplication, Gastric Bypass, Gastric Sleeve); Colorectal Surgery (Lap/Robotic Colectomy, Ileocolic Resection, Open Colectomy); Thoracic (Lung Lobectomy); Urologic (Robotic Cystectomy, Radical Prostatectomy, Partial Nephrectomy). Able to provide informed consent Non-English speakers will be included with the use of short forms in the 7 available languages Must have access to an IOS or Android device Exclusion Criteria: Unable to provide consent Not undergoing procedure of interest Admitted to ICU directly after operation (except esophagectomy, where all patients are admitted to ICU directly after the operation) Use of walker, cane, or wheelchair at baseline Presence of physical limitations on walking (i.e. amputation) Usual place of residence is skilled nursing facility Cognitive inability to follow directions to maintain activity monitor in place Unable to place activity monitor on patient's wrist

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This randomized controlled trial will involve two arms: (1) and intervention arm consisting of activity monitor feedback loop and art tours and (2) control group consisting of standard of care.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Arm<br>Intervention: Activity monitor feedback loop: (1) Subjects will receive activity monitor with feedback on daily step count from the in-room TV screen, and (2) access to the Art Tour application | Other: Activity monitor feedback loop<br>* The intervention arm will test if the feedback system (i.e., activity monitor, real-time feedback, and art tours) increases daily step count, decreases length of stay, and improves patient and provider communication, patient awareness of step count goals, and patient confidence in accomplishment of daily goals.<br>|
| No Intervention: Standard-of-care Arm<br>Subjects in the control arm will receive a blinded activity monitor post-op (without feedback on step count) and the usual standard of care. Nurses and doctors will not monitor ambulation with the activity monitor, they will use standard methods of observation. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Daily Step Count | Daily step count will be captured with activity monitor | During hospitalization within approximately 1-2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of stay | Length of stay in intervention arm compared to control | Within approximately 1-2 weeks, Date patient was admitted through hospital discharge | 
| Patient Satisfaction | Patient satisfaction measured using likert-scale rated items. Scale measures patient/physician communication, patient awareness of step goals, and patient confidence in accomplishment of daily goals. The following scale ranges will be used: Never, Once a day, Twice a day, Three times a day, More than three times a day Much lower, Lower, About the same, Higher, Much higher Not at all, Slightly, Moderately, Very, Extremely Positive answer in likert-scales indicate higher patient/physician communication, patient awareness, and patient confidence in accomplishing daily step goals. | Within approximately 1-2 weeks, Day patient is discharged from hospital | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ambulation, Length of stay, Patient Satisfaction, Activity Monitor, Digital Health