A quick mobility screening method used by all disciplines and levels of healthcare professionals can provide certainty about a patient's current ability and appropriate technology for mobilization, as well as a common language for this mobility level that is understood throughout the enterprise. The Department of Veterans Affairs (VA) has modified the Bedside Mobility Assessment Tool (BMAT), which was only approved for use by registered nurses, into a tool usable by all clinical personnel and requiring less clinical judgment. Testing revealed high inter-rater reliability in multiple disciplines, allowing use across the continuum of care. We will describe how a simple mobility screen can make patient care safer and more efficient in hospital, clinic, rehab, vehicle, community, and home care. We will explain how and why we developed this mobility screening tool after multiple VA facilities started to make their own modifications to BMAT. We will describe the tool, the testing method, and testing results, as well as outcomes from facilities that have started to implement this tool. And we will introduce visual tools to provide guidance on how to accomplish multiple mobility goals given a current mobility level.
1. Describe the risks of not having all frontline staff who screen patients be able to choose safe mobility methods.
2. Use a mobility screening tool to choose safe patient handling and mobility technology.
3. Use a mobility screening tool to choose safe methods to achieve a patient's maximum safe level of mobility.
4. Describe how a mobility assessment used across the continuum of care can improve patient safety, staff safety, and patient mobility.
Marie Martin is an industrial hygienist by training, with her PhD in Occupational and Environmental Health Sciences from the University of Washington. She led curriculum for an Occupational Safety and Health Administration (OSHA) training center before joining the VA North Texas Health Care System as an industrial hygienist in 2008. Within two months of arrival, she was planning for ceiling lifts, and she has been an SPHM facility coordinator ever since. In 2014, she started helping with the national VA SPHM program, led it from 2015 to 2016, and has assisted with its leadership ever since.
Margaret Arnold is CEO of EarlyMobility.com and of Inspire Outcomes. She has 30 years' experience as a physical therapist and 20 years as an ergonomic evaluation specialist and safe patient handling/ early mobility expert, holding certification as a Safe Patient Handling Professional. She has published extensively on early mobility and safe patient handling, and she is the Editorial Advisor on Early Mobility to the International Journal of Safe Patient Handling and Mobility. Margaret sits on the Board of Directors for ASPHP, where she chairs the Education Committee and leads a national task force to integrate SPHM into graduate education for physical and occupational therapists, nurses, radiology technicians, and medical doctors. Margaret is passionate about patient outcomes, as well as protecting those who care for patients, and she has done a TED talk on this very topic. She is working with more than 50 VA facilities nationwide to help move toward safe early mobility across care settings and disciplines.
Susan Wyatt, RN, BSN With dual degrees in Biology and Nursing, Susan recently retired from the Phoenix VA Health Care System where she successfully developed the Safe Patient Handling and Mobility (SPHM) Program, decreasing direct care staff lifting and repositioning injuries by greater than 70%. She has provided over a decade of program mentorship for multiple VA facilities and formally within her VISN serving as program lead. Observing structure variances between systems for this complex program, she developed a scoring matrix tool based on national VHA directive to provide systematic assessment of facility program implementation to help facilities quickly identify gaps.
Susan specializes in developing interdisciplinary SPHM and Early Mobility processes, staff and patient education, workflow, product distribution and ergonomic evaluations to identify high risk patient care tasks and solutions to prevent related patient and staff injuries. Utilizing SPHM as a foundation framework, she co-led a multidisciplinary team to implement early mobility in the ICU, publishing the process in Integrating Safe Patient Handling and Early Mobility: Combining Quality Initiatives.
Recognizing the importance of high reliability in multidisciplinary early mobility process implementation across systems, Susan recently served with an elite team nationally as SME to create a statistically valid VA mobility tool to link common mobility screening language with SPHM equipment to promote safety and patient mobilization across the spectrum of care.
Through years of experience and observation, Susan believes choosing to continue working as Senior Consultant for EarlyMobility.com solidifying the link between SPHM and Early Mobility is logical and imperative for all, including facility, staff, patient and family. Favorite quote: "Do the best you can until you know better. Once you know better, do better." Maya Angelon.