Clinical trial NCT03874767: Can Mobility Technicians Provide Value to Hospitalized Patients?
Official title: Can Mobility Technicians Provide Value to Hospitalized Patients?
Study type: INTERVENTIONAL
Overall status: WITHDRAWN
Phase: NA
Conditions: Hip Fractures
Lower Extremity Fracture
Lung Transplant
Keywords: patient mobility
ambulation
Lead sponsor: Vanderbilt University Medical Center
Sponsor class: OTHER
First posted: 2019-03-14
Enrollment: 0
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: single center, pragmatic cluster trial
Primary purpose: TREATMENT

Brief summary: The specific aim of this study is to determine the impact of the addition of a dedicated mobility technician to the care team on specialty specific outcomes for patients recovering from surgical treatment for a hip or lower extremity long bone fracture or a lung transplant.

The practice of post-operative early ambulation has been shown to improve outcomes by promoting enhanced recovery after surgery in a variety of patients. To that end, VUMC is establishing a "Culture of Mobility". To do so, additional personnel are being hired to help ambulate patients with traumatic hip and femur fractures, other fractures of the lower extremity long bones, as well as those post-lung transplant or readmitted post-lung transplant based upon the best available evidence supporting mobility programs. The added personnel are needed as the currently available resources have insufficient bandwidth to ensure complete early ambulation for all patients. The relative effectiveness of adding a dedicated resource is assumed. Although the literature suggests adding person-hours increases the amount of mobility achieved, there is an opportunity to evaluate whether this is really the case.

The goal of this study is to evaluate the impact of adding the mobility technician to the existing care team. The mobility technician will be assisting patients who could benefit from early ambulation after surgery. We hypothesize that by adding this staffing resource, more patients will get the appropriate level of usual care. Specifically, we expect that adding the resource increases the proportion of those patients who are receiving the prescribed amount of early ambulation post-surgery, with subsequent improvements in functional independence at discharge, and decreases length of stay since patients achieve readiness for discharge sooner.


Eligibility criteria: Inclusion Criteria:

* All traumatic fractures of the hip or a lower extremity long bone
* Post-lung transplant patient
* Patient readmitted following a lung transplant

Exclusion Criteria:

* Non-traumatic joint replacements
* Patients with ankle fractures
* Pre-lung transplant patients
* Patients readmitted to the orthopedics unit following a traumatic injury

Primary outcomes:
measure: Length of Stay
timeFrame: Admission to discharge (usually less than 1 week)
measure: AM-PAC 6 Clicks score
timeFrame: 7 days post ICU discharge +/- 1 day for post-lung transplant patients and day 7 +/- 1 days for readmitted post-lung transplant patients. Raw scores range from 6-24, where a lower number suggests higher functional/mobile impairment.
Secondary outcomes:
measure: Function Independence Measurement (FIM) score
timeFrame: At discharge (usually less than 1 week after admission)
measure: Johns Hopkins Highest Level of Mobility (JH-HLM) score
timeFrame: At discharge (usually less than 1 week after admission)
measure: Total amount of mobility therapy
timeFrame: Admission to discharge (usually less than 1 week)
measure: Amount of ambulation
timeFrame: Admission to discharge (usually less than 1 week)
Other outcomes:
Locations:
city: Nashville
country: United States
facility: Vanderbilt University Medical Center
state: Tennessee
Study officials:
affiliation: Vanderbilt University Medical Center
name: Heather Skaar, PT
role: PRINCIPAL_INVESTIGATOR
References: