EP553 - Mobility Technician Outcomes After Ambulatory Restriction Fall Prevention Strategy Implemented

Purpose/Background: In January of 2023 a new system-wide initiative was implemented to decrease the number of patient falls in our hospital system. This initiative significantly limited the ability for patients to ambulate on their own, and the scarcity of support staff available to assist them led to inability for patients to ambulate more than once daily. It is well known that patients need to ambulate after surgery to expedite recovery. It aids in pain management, bowel recovery, lung compliance and prevents DVTs, atelectasis, and pressure wounds. This new initiative severely decreased the freedom our patients had to ambulate post-operatively, which is in direct opposition to our post-operative instructions and ERAS protocols. This created the need for mobility technicians to be hired, to ambulate post-operative patients on the surgical floor of our institution.

Methods/Interventions: We completed a retrospective observational study, reviewing data from elective, post-op colorectal patients prior to the implementation of this new protocol and subsequent hiring of mobility technicians, as well as 1-year post-implementation. Hospital length of stay (LOS) was our primary outcome measure, however we also captured falls, post-operative complications, 30-day readmission rate, and other patient-related characteristics.

Results/Outcomes: Our results demonstrated a statistically significant decrease in LOS after the hiring of mobility technicians. The data tracked number of ambulations over the course of the year and as this number increased (with the hiring of more techs), the LOS decreased. The other outcomes reviewed did not show any significant difference. Of note, there were no falls in our post-operative colorectal surgical patients.

Conclusion/Discussion: It is common practice for post-operative patients to be encouraged to ambulate. This has been shown time after time to aid in healing, return of bowel function, and pain management. Ambulation is part of the heavily studied and verified ERAS protocol. Our hospital implemented a system-wide restriction on ambulation to prevent falls, which severely impacted our post-operative patients. Luckily, our surgical floor was able to hire mobility technicians who, over the course of 1 year, decreased our colorectal post-op LOS. This study highlights the crucial need for ambulation post-op and how blanket safety initiatives can impose negative restrictions on certain patient types. Further study is ongoing in the impacts and cost-effectiveness of this protocol across a broader range of specialties and patients.

Figure 1: Median LOS
Figure 1 demonstrates the data points over the 1 year post-implementation of the initiative corresponding to LOS.