Previous studies conducted at RBWH tell us that patients in our medical wards walk less than 450 steps daily, well below the 900 steps required to prevent deconditioning. Despite attempts to improve this situation, mobility levels remain stubbornly low. This study built on previous work to understand why it is difficult for patients to be active in the hospital.

Getting patients up and moving in the hospital is essential for preventing a range of complications such as delirium, functional decline, pneumonia, blood clots and skin breakdown. To understand better the low mobility observed and to provide leadership in changing this, Dr Adsett’s team surveyed medical staff in Metro North Health (MNH), investigated equipment and environments within the MNH hospitals and reviewed international literature to find out ‘what works’ to improve mobility levels in hospitalised medical patients.

Ultimately, the team aims to reduce hospital-associated complications such as functional decline and falls and thus decrease the time that people spend in the hospital and the need for patients to be discharged to destinations other than their homes.

The results from this study confirmed the low activity undertaken by MNH hospital patients. For example, only 1/3 of the patients left their beds on a given day, while 50% walked very short distances. Several barriers were identified, among them poor records of patients’ pain levels. Moreover, there is an inconsistent staff encouragement of patients to be active, which was linked to a fear of risk of falls and a cluttered environment, with equipment occupying large areas within the wards. By observing a lack of policies to promote physical activity and mobility, this project has led to the formation of a Multi-professional Mobility Improvement Collaborative, which will work together to make mobility and the prevention of functional decline a priority.