AMP Step Wedge Trial

Disability Clinical Trial

— AMP SWT  

Official title:

Activity and Mobility Promotion (AMP): Implementation and Impact of a Multifaceted Intervention to Increase Mobility in Hospital Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05021679
• Other study ID #: IRB00270215
• Status: Completed
• Phase: N/A
• Start date: January 1, 2021
• Est. completion date: April 1, 2024

Study information

• Verified date: April 2024
• Source: Johns Hopkins University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 16676
• Est. completion date: April 1, 2024
• Est. primary completion date: April 1, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

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

Related Conditions & MeSH terms

• Disability
• Immobility

Intervention

Other:
• AMP Implementation
Each study site will implement the Johns Hopkins AMP program at different times. The AMP program includes nursing staff training on the goals of AMP, how to complete mobility-focused outcome measures, set mobility goals, and to safely mobilize/ambulate patients. The AMP program also includes embedding these outcome measures and mobility goals into electronic medical records and producing weekly/monthly reports that show how often nursing staff score patient mobility and help patients meet daily activity goals.

Locations

Country	Name	City	State
United States	Johns Hopkins Hospital	Baltimore	Maryland

Sponsors (1)

Lead Sponsor	Collaborator
Johns Hopkins University

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	% of patients meeting daily mobility goal	Mobility goal is set and measured using the Johns Hopkins Highest Level of Mobility (JH-HLM) Scale	39 months
Primary	% of patients with mobility measurements documented daily	Mobility documentation to include Activity Measure for Post-Acute Care (AM-PAC) and JH-HLM	39 months
Primary	% of patients receiving physical and/or occupational therapy consults	To be extracted from electronic medical record	39 months
Secondary	Hospital length of stay (days)	To be extracted from electronic medical record	39 months
Secondary	Discharge disposition status	Count of where patients are discharged to (e.g,. home, inpatient rehab unit) assessed by extraction from electronic medical record.	39 months
Secondary	Number of physical and occupational therapy visits received during inpatient stay	To be extracted from electronic medical record	39 months
Secondary	Number of hospital-acquired morbidities	Includes falls, pressure injury, and venous thromboembolism. To be extracted from electronic medical record	39 months
Secondary	Number of patients with 30-day readmissions	To be extracted from electronic medical record	39 months
Secondary	Employee injuries resulting from patient mobilization	Number of employee injuries from facilitating patient mobility as assessed by medical record extraction	39 months