Effects of an Ambulation Orderly Program Among Cardiac Surgery Patients

Saki Miwa, Paul Visintainer, Richard Engelman, Amanda Miller, Tara Lagu, Erin Woodbury, Peter K. Lindenauer, Quinn R. Pack*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background Despite the known benefits of ambulation, most hospitalized patients remain physically inactive. One possible approach to this problem is to employ “ambulation orderlies” (AOs) – employees whose main responsibility is to ambulate patients throughout the day. For this study, we examined an AO program implemented among postcardiac surgery patients and its effect on patient outcomes. Methods We evaluated postoperative length of stay, hospital complications, discharge disposition, and 30-day readmission for all patients who underwent coronary artery bypass or cardiac valve surgery in the 9 months prior to and after the introduction of the AO program. In addition to pre-post comparisons, we performed an interrupted time series analysis to adjust for temporal trends and differences in baseline characteristics. Results We included 447 and 478 patients in the pre- and post-AO intervention groups, respectively. Postoperative length of stay was lower in the post-AO group, with median (interquartile range) of 10 (7, 14) days vs 9 (7, 13) days (P <.001), and also had significantly less variability in mean monthly length of stay (Levene's test P =.03). Using adjusted interrupted time series analysis, the program was associated with a decreased mean monthly postoperative length of stay (−1.57 days, P =.04), as well as a significant decrease in the trend of mean monthly postoperative length of stay (P =.01). Other outcomes were unaffected. Conclusion The implementation of an AO program was associated with a significant reduction in postoperative length and variability of hospital stay. These results suggest that an AO program is a reasonable and practical approach towards improving hospital outcomes.

Original languageEnglish (US)
Pages (from-to)1306-1312
Number of pages7
JournalAmerican Journal of Medicine
Volume130
Issue number11
DOIs
StatePublished - Nov 2017
Externally publishedYes

Keywords

  • Ambulation
  • Cardiac surgery
  • Hospital outcomes
  • Mobility

ASJC Scopus subject areas

  • Medicine(all)

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