Do Mobility Technicians Provide Benefit to Patients Recovering From Hip or Lower Extremity Long Bone Fracture Surgery?

The change in Medicare payment for Surgical Hip and Femur Fracture Treatment (SHFFT) patients
gave hospitals an incentive to provide higher quality care to this cohort of patients. The
practice of post-operative early ambulation has been shown to improve outcomes by promoting
enhanced recovery after surgery in a variety of patients, include those with SHFFT. To that
end, Vanderbilt University Medical Center (VUMC) is establishing a "Culture of Mobility". To
do so, additional personnel are being hired to help ambulate patients with traumatic hip and
femur fractures, and other fractures of the lower extremity long bones, based upon the best
available evidence supporting mobility programs. The added personnel are needed as the
currently available resources have insufficient bandwidth to ensure complete early mobility
for all patients. The relative effectiveness of adding a dedicated resource is assumed.
Although the literature suggests adding person-hours increases the amount of mobility
achieved, there is an opportunity to evaluate whether this is really the case.

The goal of this study is to evaluate the impact of adding the mobility technician to the
usual care team in order to assist patients who could benefit from early ambulation after
surgery. We hypothesize that adding a dedicated mobility technician increases the proportion
of prescribed early ambulation provided to all eligible patients post-surgery, improves
functional independence at discharge, and decreases length of stay since patients achieve
readiness for discharge sooner than without early mobility.