Want to recover faster after surgery? Keep moving while in the hospital

Want to make a hospital stay better? Keep moving as much as you can.

It might seem counterintuitive as you lie in a hospital bed, but using your muscles can make recovery easier, according to Julie Drake, executive director of rehabilitation services for Cape Cod Hospital and Falmouth Hospital. And now, a new Cape Cod Healthcare initiative will encourage patients to be as mobile as possible within their limits of health and safety.

“We know that if a patient exercises and is more mobile, then they’re not going to become as deconditioned while they’re in the hospital,” Drake said. “If they’ve become weaker in the hospital, then they may have to be discharged to a skilled nursing facility for rehab because they’re not safe to go home. We know most patients do best if they can return to their home after a hospitalization, if that’s a safe option for them.”

Of course, no one expects a postoperative patient to jog through the hallways or do jumping jacks. The right amount of mobility will vary from patient to patient. For some, it might mean a short stroll down the hallway. For others, it’s simply moving from lying in bed to sitting on the edge of the bed, eating lunch upright in a chair, or walking to the bathroom instead of using a commode, Drake said.

The goal is to keep patients moving, with the understanding that they are in the hospital for a reason and not at their best, she said.

“There are so many benefits of mobility – decreased risk of pressure sores, improved circulation, improved breathing, minimized muscle loss and deconditioning,” she added.

Cape Cod Healthcare’s initiative starts with nursing staff, who will be encouraged to look for opportunities to get patients moving and track it. Nurses and nursing assistants will now document a patient’s mobility along with other vital statistics such as blood pressure, weight and fluid intake. Patients will be evaluated based on their ability to, for example, move from the bed to the chair unassisted.

Nurses are already encouraged to check on patients hourly, making sure their needs are met and personal items are within reach. Now they might ask if a patient wants to get up to sit in a chair or take a short walk, Drake said.

Patient Mobility Score

Each patient will have a daily mobility score and goal. Drake and her staff want to create a common language and scale among staff so that if there’s, say, a mobility score of 5, everyone knows the patient was able to stand for one minute or more at the edge of the bed. That also allows staff to set new goals each day.

“So, you can say, OK, the patient was able to walk 25 feet today and so we’re going to set the goal at 250 feet and see if we can achieve that tomorrow,” she said.

And there’s another goal related to patient mobility: Better conditioning can help prevent patient falls. Patients need to move and walk to maintain their strength and to avoid complications of bed rest, according to the U.S. Agency for Healthcare Research and Quality.

Nationwide, there are between 700,000 and 1 million falls in hospitals annually, and more than a third of them result in injury, according to the federal agency. Cape Cod Healthcare’s rate tends to hover around the national benchmark fall rate, but we want to do better, said Drake, a member of Cape Cod Healthcare's committee charged with reducing falls. The healthcare system is committed to improving its numbers, she said.

“We looked into the reasons and circumstances under which patients were falling and noted that many of them were not getting out of bed daily, weren’t walking, weren’t sitting up in a chair for meals, and would benefit from being more mobile during their hospital stay,” she said.

Some patients, particularly older ones, may need a bit more encouragement. For example, Drake said she is more likely to see younger patients taking a stroll down the hall.

“I think we, as a healthcare system, have become so afraid of patients falling that we’re taking it to the extreme and limiting their activities so much that it’s got detrimental effects,” she said. “We’re trying to get away from that. If we can mobilize them safely, then that’s what is going to be best for the patient.”