Randomized Trial of Assisted Ambulation to Improve Health Outcomes for Older Medical Inpatients
The Cleveland Clinic
Summary
The investigator proposes to conduct a randomized trial of supervised ambulation delivered by mobility technician (MT) up to three times daily, including weekends, to hospitalized medical patients. The aims of the study are to compare the short and intermediate-term outcomes of patients randomized to the intervention versus those patients randomized to receive usual care, to identify patients who are most likely to benefit from the intervention and to assess whether the intervention increases or decreases overall costs of an episode of care, including the cost of the MTs, the index hospitalization and the first 30 days post enrollment.
Description
The investigator proposes to conduct a large randomized trial to test the impact of MTs (Mobility Technicians) on short and intermediate term outcomes for 3000 patients aged 65 years and older at 5 hospitals in 2 health systems. Patients will be randomized to receive supervised ambulation up to 3 times daily with a MT or to receive usual care. All participants will wear an accelerometer on their wrist to track their movement throughout the hospital stay. The study has 3 aims. First, the study will compare the mobility of patients at discharge (or 10 days) to assess the impact of the MTs on thi…
Eligibility
- Age range
- 65+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: Participants must meet all of the inclusion criteria listed below to participate in this study: 1. ≥65 years of age 2. Admitted to a medical service 3. Complete history and physical examination on file 4. 6-Clicks score of 16-23 5. Insurance with Traditional Medicare or Medicare Advantage Exclusion Criteria: Any patient meeting any of the exclusion criteria listed below at baseline will be excluded from study participation: 1. Significant language barrier that requires a translator (other than Spanish at Baystate site only) 2. Discharge planned for that day or the foll…
Interventions
- BehavioralMobility technician
Designated mobility technicians (MT) will ambulate hospitalized medical patients up to 3 times daily, 7 days per week, until discharge or a maximum of 10 days. Each day, the MT will visit the patient 4 times or until the patient successfully ambulates 3 times that day. In cases where a PT has provided a recommendation in the patient's chart, the MT will follow the recommendation, if feasible. Otherwise, the MT will execute the standard mobility protocol. The mobility protocol will allow the MT to assist a patient with an appropriate out-of-bed activity based on their 6-clicks score from the immediately preceding session.
Locations (5)
- Baystate Medical CenterSpringfield, Massachusetts
- Fairview HospitalCleveland, Ohio
- Cleveland Clinic- Main CampusCleveland, Ohio
- Marymount HospitalGarfield Heights, Ohio
- Hillcrest HospitalMayfield Heights, Ohio