MOVE ON

Mobilization of Vulnerable Elders in Ontario (MOVE ON) ARTIC Project

Rates of mobilization in patients admitted to acute care hospitals are unacceptably low. Studies show that hospitalized older adults who were ambulatory during the two weeks prior to admission spent a median of only 43 minutes per day standing or moving. Without mobilization, elderly patients lose 1 to 5% of muscle strength each day in hospital. In addition, one-third of older adults develop a new disability in an activity of daily living during hospitalization and half of these patients are unable to recover function. Data from observations on inpatient units conducted in 2010-2011 in academic hospitals in Toronto found that less than 30% of patients were regularly mobilized in hospital.

The MOVE ON ARTIC Project aims to improve in-hospital mobilization of elderly patients through implementation of an education intervention. Developed jointly by Sunnybrook Health Sciences Centre and St. Michael’s Hospital, the MOVE ON ARTIC Project involves a collaboration with 14 CAHO member hospitals (Baycrest Health Sciences, Hamilton Health Sciences, Health Science North, Kingston General Hospital, London Health Science Centre, Hôpital Montfort, Mount Sinai Hospital, North York General Hospital, The Ottawa Hospital, St. Joseph’s Healthcare Hamilton, St. Michael’s Hospital, Sunnybrook Health Sciences Centre, Thunder Bay Regional Health Sciences Centre and University Health Network).

Between 2010 and 2013, MOVE ON was successfully implemented across participating hospitals. There were many key achievements of the MOVE ON ARTIC Project:

  • bolstered, facilitated and ensured quality-driven, patient-centred care by challenging the often accepted notion that rest is best;
  • reduced the length of stay by a half day (observed), which speaks to an improved quality of life for patients and their families, and savings to the health care system;
  • increased the mobility rate of elderly patients, which we know from existing research improves health outcomes for this vulnerable population;
  • utilized existing resources, fostered inter-professional collaboration and facilitated natural opportunities to include mobilization in staff workflow, thereby demonstrating the Project’s feasibility and sustainability, and aligning the Project with hospital and provincial priorities.

MOVE-ing ON

The MOVE ON project continues to be implemented at seven of the 14 original CAHO hospital sites in an extension of the project called MOVE ON +. The purpose of MOVE ON + is to determine the effectiveness of the education intervention in hospital units of different types (e.g. surgery, mental health).

MOVE ON has also been scaled up and rolled out as corporate initiatives at three of the 14 participating hospitals, demonstrating the alignment of MOVE ON with institutional priorities.

Finally, the MOVE ON project identified that patients and their families are key partners on the path to improving in-hospital mobilization. It is important that elderly patients and their social networks understand the benefits of mobilization to realize the full benefits of an intervention like MOVE ON. To help engage patients and their families, the MOVE ON ARTIC Project team developed “Motions of Recovery,” a public service announcement video funded by CAHO that can be freely used by others interested in implementing key messages regarding early mobilization at their hospital sites.

The “Motions of Recovery” video can be seen here: https://www.youtube.com/watch?v=MVymx7zH86A&list=UUXyfbvQ6wgYWg6WXCaxY1gA