Samenvatting

Objective. Hospital in Motion is a multidimensional implementation project aiming to
improve movement behavior during hospitalization. The purpose of this study was to
investigate the effectiveness of Hospital in Motion on movement behavior.
Methods. This prospective study used a pre-implementation and post-implementation
design. Hospital in Motion was conducted at 4 wards of an academic hospital in the
Netherlands. In each ward, multidisciplinary teams followed a 10-month step-by-step
approach, including the development and implementation of a ward-specific action plan
with multiple interventions to improve movement behavior. Inpatient movement behavior
was assessed before the start of the project and 1 year later using a behavioral mapping
method in which patients were observed between 9:00 am and 4:00 pm. The primary
outcome was the percentage of time spent lying down. In addition, sitting and moving,
immobility-related complications, length of stay, discharge destination home, discharge
destination rehabilitation setting, mortality, and 30-day readmissions were investigated.
Differences between pre-implementation and post-implementation conditions were analyzed
using the chi-square test for dichotomized variables, the Mann Whitney test for
non-normal distributed data, or independent samples t test for normally distributed data.
Results. Patient observations demonstrated that the primary outcome, the time spent
lying down, changed from 60.1% to 52.2%. For secondary outcomes, the time spent sitting
increased from 31.6% to 38.3%, and discharges to a rehabilitation setting reduced from 6
(4.4%) to 1 (0.7%). No statistical differences were found in the other secondary outcome
measures.
Conclusion. The implementation of the multidimensional project Hospital in Motion
was associated with patients who were hospitalized spending less time lying in bed and
with a reduced number of discharges to a rehabilitation setting.
Impact. Inpatient movement behavior can be influenced by multidimensional interventions.
Programs implementing interventions that specifically focus on improving time spent
moving, in addition to decreasing time spent lying, are recommended.