Improving ambulation during a hospital stay
Lead Researcher: Barb King, PhD, RN, APRN-BC; UW-Madison School of Nursing
What is the focus of your research?
The focus of my research is to improve outcomes for hospitalized older adults. The route I’m taking to do this is to find out how we can improve ambulation during a hospital stay.
How has stakeholder engagement helped your project so far?
I have interviewed patients one-on-one about their experiences during hospital stays. I have also been working with a Patient Advisory Board of older adults since January, 2018. The stakeholders on my advisory board have provided us with so much information about how patients think about and perceive their experiences related to hospital stays and ambulation.
For example, I’ve learned how frightening and isolating hospitals can be for patients – I don’t think that I truly realized this before. What kind of fear are we imposing on our older patient population? We have to rethink what hospital environments do and how we can make them better. Having places that patients can walk to is necessary, like the garden patios at UW-Hospital. We have to figure how to do this inside the hospital during colder months too. We should structure hospital environments that are comfortable for patients and provide a place to socialize together. This is critically important to the healing process.
Also, it has been interesting to learn about the differences in perspective between patients and healthcare staff. For example, patients can be identified as a fall risk during their stay. This is something that hospital staff do to provide good care and keep patients safe. It might include putting a motion sensor alarm on a patient’s bed so that if they get up, healthcare staff will be able to get there quickly to make sure the patient is okay. Patients may have an entirely different perspective on whether or not they are a fall-risk. In addition, they see the alarms as a tether to keep them in bed – loud, frightening and unnecessary. It really shows that we don’t always understand how patients want to be treated. Working with my Patient Advisory Board is really informing how we think about patient-centered approaches to improve ambulation.
In addition, having the CARDS look at our recruitment materials was so valuable! I had used plain language and thought that would be enough, but hearing the CARDS feedback as they reviewed our recruitment flyer and letter was really helpful. They told us when things were confusing or frightening, and offered suggestions for how we could be clearer and less wordy with our language. This helped us create recruitment materials that were effective – they made people more likely to say, “Yes I’d like to be involved!”
What is a lesson you’ve learned from your stakeholder engagement work?
Oh gosh I have learned so much! What I found really eye opening was the recruitment process for my Patient Advisory Board. I thought I was offering a good amount of money as payment for participants, and that this alone would be really enticing. I learned that it takes a personal touch and building connections to recruit participants to an advisory board. I was fortunate to have included WINRS in my grant budget. They helped us connect with two community centers in Madison. WINRS set up meetings for us with key staff at the Goodman Community Center and the Lussier Community Education Center, and those staff enabled us to move forward much more quickly with recruitment. Otherwise, who knows, I might still be looking for people for my advisory board!
What WINRS services were provided to your team?
- CARDS meeting to review a recruitment flyer and recruitment letter
- Advice on recruiting community members for Patient Advisory Board (PAB); Arranged meetings with key community center contacts
- Targeted orientation program, developed and co-delivered by WINRS staff, for Patient Advisory Board
- Ongoing coaching to create effective meeting agendas and activities to support stakeholder engagement
Each month, WINRS interviews research teams we’ve worked with to ask about the benefits and challenges related to stakeholder engagement. If you’d like to be interviewed, please email svabek@wisc.edu