Culture of Mobility on an Oncology Unit: Every Movement Matters

Background and/or Objectives: Lack of physical activity in hospitalized patients has been linked to increased resource utilization and morbidity. Early mobilization and patient engagement have been shown to be effective in reducing length of stay and complication rate in intensive care units (ICU) and general medical/surgical wards. Our objective was to investigate whether a pragmatic physical activity education program for staff, patients and caregivers could be effective in a medically complex oncology cohort.

Design: retrospective cohort study

Setting: Tertiary medical center

Participants: Cases: 521 patients admitted to an oncology floor beyond 48 hours, excluding end-of-life care recipients, 10/01/2021- 2/28/2022. Controls: 545 patients admitted to an oncology floor beyond 48 hours, excluding end-of-life care recipients, 10/01/2019-2/28/2020.

Interventions: We investigated attitudes of patients and staff regarding physical activity during hospitalization. Based on their feedback we created educational content, reduced physical barriers, and promoted common language with ability-specific activity goals in daily patient encounters.

Main Outcome Measures: Mortality, length of stay (LOS), rates of ICU admission, rapid response team activation (RRT), high-flow nasal cannula use (HFNC).

Results: Compared with the pre-intervention period, mortality decreased from 4.57% to 0.77%, ICU admission rate declined from 9.32% to 2.87%, RRT activation rate declined from 11.7% to 6.7%, HFNC use fell from 6.22% to 3.26%. While LOS did not change, the difference between expected and observed LOS favored the intervention cohort, declining from 2.57 days to 0.16 days, indicating that the physical activity intervention reduced the number of days that patients remained on the unit beyond what was projected on admission.

Conclusions: Immersive education campaign promoting physical activity based on patients' current ability levels can reduce resource utilization and mortality among hospitalized oncologic patients.