Ban Bedcentricity: A Multifaceted Innovation to Reduce Sedentary Behavior of Patients During the Hospital Stay.
Niek Koenders, Sandra Potkamp-Kloppers, Yvonne Geurts and 3 others
PMID 33564890WHAT IT FOUND
A hospital-wide initiative to reduce bed rest showed mixed results.
Patients on two cardiac wards spent less time lying in bed and were more likely to go home. However, orthopedic patients showed no change in bed rest and actually stayed in the hospital longer.
Key findings
01Patients on the cardiothoracic surgery and cardiology wards were observed lying in bed significantly less often after the intervention, while orthopedic patients showed no significant change in bed rest.
02Cardiology patients had a shorter hospital stay and were more likely to be discharged home after implementation, whereas orthopedic patients had a longer hospital stay with no significant difference in discharge destination.
03The intervention was a multifaceted package including staff coaching, patient information, new equipment like walkers, and physical changes to the ward environment, making it impossible to attribute results to any single component.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study design was before-after without a control group, so it cannot prove causation. Other hospital-wide changes or seasonal factors could explain the differences. The intervention was multifaceted (coaching, equipment, renovation, information), so it is impossible to know which specific component drove the results. There was no process evaluation, so it is unknown how well the staff actually adopted the new practices or how much the patients used the new equipment. The orthopedic results may be confounded by the fact that many patients had lower extremity fractures with weight-bearing restrictions, making the standard 'move more' advice less applicable. Behavioral observations were limited to 30 hours total across all wards, which may not capture the full range of patient activity patterns.
Declared interests
Funded by Radboudumc University. No other conflicts of interest are explicitly detailed in the provided text, but the authors were part of the project team implementing the innovation.
The easy way to misread this
Do not interpret the mixed results as evidence that the intervention failed overall or worked everywhere. The significant benefits seen in cardiac wards did not translate to orthopedic wards, where patients actually stayed longer. This suggests the intervention's effectiveness is highly dependent on the patient population and their physical restrictions.