Improving Patient Mobility: Outcomes of a Rehabilitation and Mobility-Focused Clinical Pathway for Lung Transplant Recipients

ABSTRACT Introduction: The purpose of this study was to examine the effect of a rehabilitation and mobility-focused clinical pathway (RCP) on timing and frequency of physical therapy, functional mobility scores, discharge locations, and length of stay (LOS) for lung transplant recipients. Review of Literature: Research investigating clinical pathways involving physical therapy for lung transplant recipients is limited. Subjects: The control group (n = 68) received lung transplants pre-RCP, and the intervention group (n = 71) received lung transplants post-RCP. Methods: The RCP was implemented at a large academic hospital as a quality improvement initiative. This retrospective study included 139 lung transplant recipients. Time to physical therapy evaluation, frequency of physical therapy sessions, Activity Measure for Post-Acute Care “6-clicks” scores, Johns Hopkins Highest Level of Mobility Scores, discharge locations, and LOS were measured. Results: The intervention group demonstrated a 27.3% decrease in time from consult to physical therapy evaluation (95% confidence interval [CI]: −39.9%, −11.9%; P < .001), an increase of 1.14 physical therapy sessions per week (95% CI: 0.78, 1.49; P < .0001) greater improvements in functional mobility outcomes on the Activity Measure for Post-Acute Care (1.08; 95% CI: 0.49, 1.67; P = .0004) and Johns Hopkins Highest Level of Mobility Scores (0.23; 95% CI: 0.09, 0.36; P = .001). LOS and discharge location remained similar. Discussion and Conclusions: The RCP led to improved timing and frequency of physical therapy services and improved functional mobility scores. Future studies should investigate the impact of the multidisciplinary interventions in the RCP and outcomes such as quality of life and readmission rates.