Clinical trial NCT05021679: AMP Step Wedge Trial
Official title: Activity and Mobility Promotion (AMP): Implementation and Impact of a Multifaceted Intervention to Increase Mobility in Hospital Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Immobility
Disability
Keywords: Activity
Mobility
Hospital-acquired disability
Lead sponsor: Johns Hopkins University
Sponsor class: OTHER
First posted: 2021-08-25
Enrollment: 16676
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Step-wedge clinical trial
Primary purpose: TREATMENT

Brief summary: Annually, more than 35 million patients are hospitalized in the United States. Many of these will experience hospital-acquired loss of physical functioning due to a lack of mobility during their in-patient stay. Such loss includes difficulties performing basic activities, such as rising from a chair, toileting, or ambulating. This loss of function may increase hospital length of stay (LOS), nursing home placement, and decrease mobility and participation in community activities even years after hospitalization. Prevention of this hospital-acquired functional loss is critical. Even the sickest hospitalized patients (e.g., those in the intensive care unit \[ICU\]), can safely and feasibly benefit from early mobilization. In the non-ICU setting there is evidence that patient mobilization reduces LOS and hospital costs, while improving patient satisfaction and physical and psychological outcomes. The overall objective of this proposed project is to evaluate the implementation and impact of a transdisciplinary and multifaceted mobility program (Johns Hopkins Activity and Mobility Promotion - AMP) on clinical outcomes among hospitalized adults. In addition to clinical outcomes, we will identify barriers and facilitators to high-performance program adoption. Results of this project will provide critical new insights on the effectiveness of AMP and inform dissemination and implementation nationwide.


Eligibility criteria: Inclusion Criteria:

* All adult patients admitted to study hospital unit
* Analysis will only include those with lengths of stay \>=3 days

Exclusion Criteria:

* Patients with active do-not-resuscitate (DNR) order
* \<18 years old

Primary outcomes:
measure: % of patients meeting daily mobility goal
timeFrame: 39 months
measure: % of patients with mobility measurements documented daily
timeFrame: 39 months
measure: % of patients receiving physical and/or occupational therapy consults
timeFrame: 39 months
Secondary outcomes:
measure: Hospital length of stay (days)
timeFrame: 39 months
measure: Discharge disposition status
timeFrame: 39 months
measure: Number of physical and occupational therapy visits received during inpatient stay
timeFrame: 39 months
measure: Number of hospital-acquired morbidities
timeFrame: 39 months
measure: Number of patients with 30-day readmissions
timeFrame: 39 months
measure: Employee injuries resulting from patient mobilization
timeFrame: 39 months
Other outcomes:
Locations:
city: Baltimore
country: United States
facility: Johns Hopkins Hospital
state: Maryland
Study officials:
affiliation: Johns Hopkins University
name: Sapna Kudchadkar, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: Johns Hopkins University
name: Erik Hoyer, PhD
role: PRINCIPAL_INVESTIGATOR
References: