Mobility Change Package

The Mobility Change Package and Toolkit

When older adults are hospitalized, there is an inherent tension between preventing falls and promoting mobility. In response to public and professional attention to medical errors, Medicare policy and, in turn, hospital culture have strongly prioritized preventing falls, with potential unintended consequences for patient mobility, functional abilities, and well-being (Growdon 2017). It is well-documented, however, that patient immobility in the hospital contributes to undesirable outcomes, including increased risk of injurious falls, delirium, pressure ulcers, hospital acquired infections (e.g., urinary tract infection and aspiration pneumonia), functional decline, prolonged length of stay, institutionalization, readmission, and increased healthcare costs.

While falls with injury should, of course, be avoided in the hospital, current fall prevention efforts reflect a troubling underlying assumption that keeping patients from moving can stop hospital falls. Since 2007, there has been a severe epidemic of immobility among hospitalized older adults. According to a 2009 estimate, hospital patients spend over 83% of their time in bed (Brown 2009). By contrast, current evidence suggests that early mobilization actually decreases the risk of injurious falls.

The purpose of the Mobility Change Package and Toolkit is to provide a conceptual framework, roadmap, and step-by-step guide to help you and your team implement a Mobility Program at your institution.  The materials also include a comprehensive bibliography, tools, resources, and helpful hints from sites to guide you in this process.  We hope you will find useful guidance, as well as inspiration in these pages.

How to Access

The Mobility Change Package and Toolkit is free and available for immediate download here.

This work was created by Dr. Sharon K. Inouye and is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0). To view a copy of this license, visit: