Value Proposition:
· Greater mobility and activity among hospitalized patients have been linked to key outcomes, including decreased length of stay, increased odds of home discharge, and fewer hospital-acquired morbidities. Systematic approaches to increasing patient mobility and activity are needed to improve patient outcomes during and following hospitalization.
· Published studies have found the Johns Hopkins Activity and Mobility Promotion (JH-AMP) program improves patient mobility and associated outcomes.
· Experienced interprofessional team to consult with and support facilities in the design, implementation, evaluation, and sustainability of the program.
· Fully developed toolkit and education modules
· Evidence supported clinical decision assessment and measurement tools to establish patient specific mobility goals, target clinician resources/interventions, and identify appropriate equipment to improve mobility, reduce falls and reduce clinician injury.
· Breaks down silos by integrating mobility with hospital efforts to reduce falls, pressure injury, delirium, clinician injury, VTE and other related harms.
· Integrates mobility efforts across clinical standards of care including: the Critical Care A to F Bundle, Surgery Enhanced Recovery Pathways, and Age Friendly Health Systems
Unmet Need:
Hospitalized patients unnecessarily spend approximately 83-95% of their time in bed during their hospital stay. This lack of mobility contributes to an increased risk of falls, functional decline, increased length of stay, development of pressure ulcers, pneumonia, thromboembolic disease, delirium, and higher rates of discharges to skilled nursing facilities. Systematic approaches and standardized assessment/measure systems are required to improve hospital safety/quality, clinical and operational outcomes. Most organizations do not have a systematic approach or use a common clinical decision assessment/measurement system. Combatting hospital acquired debility and resulting complications while safeguarding patient welfare would result in significant financial cost-savings for the healthcare facility and patients. (Young et al, 2022)
Technology Description:
Johns Hopkins researchers have developed the Johns Hopkins Activity and Mobility Promotion Program (JH-AMP), a systematic approach to combat immobility harm. The inter-professional program provides frontline caregivers and hospital leaders with the tools and support needed to design and implement structured quality improvement processes that can successfully increase patient activity and mobility to improve outcomes by identifying and removing barriers to patient mobility, improving team communication, and providing education.
JH-AMP is a systematic approach that includes 8 steps, described in this article: (1) organizational prioritization; (2) systematic measurement and daily mobility goal; (3) barrier mitigation; (4) local interdisciplinary roles; (5) sustainable education and training; (6) workflow integration; (7) data feedback; and (8) promotion and awareness.
1. Hospital Assessment and Project Design.
2. Education Services including courses and certification for leadership, frontline workers, and advocates.
3. JH-AMP Guides and Tools to support implementation, assessment, and evaluation.
4. Established evidence based clinical decision tools include the following:
a. Johns Hopkins Highest Level Mobility (JH-HLM)
b. Johns Hopkins Mobility Goal Calculator (JH-MGC)
c. Johns Hopkins Safe Patient Handling Mobility (JH-SPHM)
d. Johns Hopkins Activity Daily Living (JH-ADL)
5. Implementation Services including Electronic Health Record and Report Design, Consultation Calls, and Workshops
Stage of Development:
· The program is available for use.
· JH AMP tools are in use at over one thousand (1000) organizations globally and have been translated into Spanish, Portuguese, French, German and Japanese. Over 650 Hospitals have attended JH-AMP annual conference.
Program Information
More information is available:
· Activity and Mobility Promotion | Johns Hopkins Physical Medicine and Rehabilitation (hopkinsmedicine.org)
· https://www.hopkinsmedicine.org/physical-medicine-rehabilitation/education-training/amp/research#featured
· Journal of Nursing Care Quality (lww.com)
· Toward a Common Language for Measuring Patient Mobility in the Hospital: Reliability and Construct Validity of Interprofessional Mobility Measures - PubMed (nih.gov)
· A unit-based, multi-center evaluation of adopting mobility measures and daily mobility goals in the hospital setting - ScienceDirect
· Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project - PubMed (nih.gov)
· Prediction of Disposition Within 48 Hours of Hospital Admission Using Patient Mobility Scores - Young - 2020 - Journal of Hospital Medicine - Wiley Online Library
