Ban Bedcentricity: A Multifaceted Innovation to Reduce Sedentary Behavior of Patients During the Hospital Stay

Abstract

Objective The purpose of this study was to explore differences in sedentary behavior, length of hospital stay, and discharge destination of patients before and after the Ban Bedcentricity implementation at ward-level. Methods The Ban Bedcentricity innovation and implementation procedure were implemented at the cardiothoracic surgery, cardiology, and orthopedics-traumatology wards. Sedentary behavior data were collected 2 weeks before and after the implementation using behavioral observations and analyzed with Pearson’s chi-square. Length of hospital stay and discharge destination data were collected from all admitted patients and analyzed with multiple and logistic regression analyses. Results Behavioral observations showed that in 52% of the observations patients were lying in bed before implementation and 40% after implementation at the cardiothoracic surgery, 64% and 46% at the cardiology, and 53% and 57% at the orthopedics-traumatology wards. The mean length of hospital stay after implementation (compared to before implementation) was 5.1 days at the cardiothoracic surgery (n = 1923; mean + +0.13 days; 95%CI = −0.32 to +0.60), 2.6 days at the cardiology (n = 2646; mean = −0.22 days; 95%CI = −0.29 to −0.14), and 2.4 days at the Orthopedics-Traumatology wards (n = 1598; mean = +0.28 days = 95%CI = +0.06 to +0.50). After the implementation, more patients were discharged home from the cardiothoracic surgery (odds ratio [OR = 1.23]; 95%CI = 1.07 to 1.37) and cardiology wards (OR = 1.37; 95%CI = 1.22 to 1.49), and no statistically significant difference was found at the orthopedics-traumatology ward (OR = 1.09; 95%CI = 0.88 to 1.27). Conclusions The outcomes indicate beneficial outcomes after the implementation with less sedentary behavior and proportionately more patients being discharged home, compared to before the implementation. However, little information is available about the adoption and fidelity of Ban Bedcentricity, therefore, outcomes should be interpreted with caution. Impact This multifaceted innovation to reduce sedentary behavior of patients during the hospital stay seems to be promising, with outcomes indicating less sedentary behavior in patients and more patients being discharged home after the implementation.

Barriers and enablers to physical activity in patients during hospital stay: a scoping review

“…Moreover, the domains Beliefs about Consequences, Memory, Attention and Decision Process, and Social/Professional Role & Identity also contained many barriers. Several studies have targeted these domains to improve patients' physical activity levels, such as providing education to counter the belief that physical activity will result in injuries [86,88], using shift huddles to address prioritizing physical activity [89], or mapping the therapy consultation process within a multidisciplinary team to create role clarity and avoid unnecessary treatments [90]. Likewise, the domains Goals and Behavioural Regulation contained many enablers.…”

Feasibility and implementation fidelity of a co-designed intervention to promote in-hospital mobility among older medical patients—the WALK-Copenhagen project (WALK-Cph)

“…To circumvent barriers to the implementation of mobility-promoting interventions, it has been suggested to engage stakeholders in the design of interventions [ 23 ] and to tailor the interventions to stakeholder perspectives and to the local clinical context [ 24 , 25 ]. However, only a few studies have accounted for these recommendations [ 26 – 28 ] by adapting mobility interventions to the local context and assessing the effectiveness of these interventions. While studies of intervention efficacy in controlled settings may be useful for establishing the potential effectiveness of an intervention, fidelity of implementing such interventions in clinical settings can be challenged by external factors in hectic settings such as hospital wards [ 29 ].…”

Healthcare professionals feel empowered by implementing a hospital-based multifaceted intervention: a qualitative study using inductive thematic analysis

“…Inclusion criteria for the participants were: their age greater than 18 years and they had to have been working at one (or a combination) of the following hospital wards for six months or more: cardiothoracic surgery, cardiology, pulmonary diseases, orthopaedics and traumatology, neurosurgery, abdominal surgery, urology, obstetrics and gynaecology, oral- and maxillofacial surgery, cardiac care unit, or medical oncology. The participants were considered rich cases, as they were involved in the implementation of Ban Bedcentricity as an implementation officer or champion [ 10 ]. The implementation of Ban Bedcentricity was finalized at the participants’ hospital ward at the time of study sampling.…”

“…One of these multifaceted interventions is Ban Bedcentricity [ 10 ]. Ban Bedcentricity is an innovative program, which offers hospitals tools, action plans, and practical guidance.…”

“…It aims to 1) improve the mindset, knowledge, and attitude of patients, their relatives, and healthcare professionals regarding the risks of sedentary behaviour and the benefits of physically active behaviour, 2) develop and provide adequate materials to support physical activity in patients during their hospitalization, and 3) improve the culture in hospitals regarding reducing sedentary behaviour and to promote physically active behaviour in patients [ 10 ]. Results after implementation of Ban Bedcentricity indicate favourable outcomes, including reducing sedentary behaviour and a proportionately greater number of patients being discharged home [ 10 ]. However, these outcomes do not guarantee successful, long-term implementation as there may be multiple barriers [ 11 ].…”