Building a Culture of Patient-Centered Care by Prioritizing Mobility

When we think of patient-centered care at rehabilitation hospitals, demographic trends tell us that more and more patients will be the elderly in the coming years. As you develop goals and set policies when it comes to ensuring patients at your rehab facilities receive the upmost care, it is imperative that “age-friendly care” be considered. Age-friendly care is a movement aimed at improving care for older adults by prioritizing their needs and preferences. Patient-centered care for age-friendly care simply means prioritizing the individual needs, preferences, and “what matters most” to an older adult patient, ensuring their voice is heard and incorporated into their care plan. It also considers the specific challenges and considerations that come with aging.

What do the numbers tell us about the types of patients we can expect in the future? By 2030, adults aged 65 and older will outnumber children under 18 for the first time in U.S. history. Starting in 2030, when all boomers will be older than 65, older Americans will make up 21 percent of the population, up from 15 percent in 2018. By 2060, nearly one in four Americans will be 65 years and older, the number of 85-plus will triple, and the country will add a half million centenarians.

This shift – known as the “graying of America” – underscores the urgency of improving elderly care, not just for today’s patients but for ourselves in the near future.

Cultivating exceptional patient-centered care at rehabilitation hospitals requires a broader perspective when caring for the elderly. It is vital that all aspects of their well-being are considered when it comes to administrative decisions. 

Domains of Age-Friendly Care

As you have a laser focus on ensuring quality patient-centered care, it is incumbent upon all staff – including physical and occupational therapists – that they promote the highest levels of age-friendly care. For age-friendly care to be successful, leadership engagement is essential. For example, rehab hospitals should have a dedicated leader who oversees implementation, provides resources, and ensures staff training. Leadership buy-in is typically the difference between success and failure in maintaining quality age-friendly care.

There are four essential tenants – referred to as the “4Ms” – that guide age-friendly care. They are the following:

1. What Matters
2. Medication
3. Mentation
4. Mobility

The 4Ms framework is supported by five key domains:

       1. What Matters Most – Aligning care with patient goals and values. Identifying what is most important to the patient in terms of their quality of life and well-being.

      2. Medication Management – Reducing polypharmacy risks. Reviewing medications regularly to ensure they are appropriate, considering potential side effects and interactions, and optimizing medication regimens. 

     3. Mentation – Preventing and addressing cognitive decline. Assessing cognitive function, screening for dementia or delirium, and addressing mental health needs. 

     4. Frailty and Mobility – Ensuring patients maintain functional independence. Evaluating functional abilities and providing support to maintain independence in daily activities. 

     5. Social Vulnerability – Addressing isolation, transportation, and access to care. 

Requirements for Age-Friendly Care

In order to demonstrate compliance with age-friendly care, hospitals must accomplish the following goals:

• Ensure staff can consistently explain why and how they implement the 4Ms.
• Maintain clear documentation of 4Ms initiatives.
• Provide access to a written care description, SOPs, flowcharts, and checklists.
• Include 4Ms principles in employee training, job descriptions, and performance evaluations. 

Implementation Requirement:  The Centers for Medicare & Medicaid Services (CMS) has established a timeline for implementing age-friendly care. Hospitals have to attest to their measures by December 31, 2025, with actual reporting beginning in 2026. Compliance is not optional, and failure to meet reporting requirements could result in significant financial penalties.

Benefits of Patient-Centered, Age-Friendly Care (with the 4Ms Framework)

• Improved patient satisfaction
• Reduced risk of adverse events and complications
• Enhanced adherence to treatment plans
• More effective care delivery tailored to the individual patient’s needs

What is important is to document each of these 4M measures clearly and integrate them into a structured approach as opposed to starting from scratch. Early mobility should align seamlessly with the 4Ms. 

Mobility is a Key Component in Patient-Centered Care at Rehab Hospitals 

As older adults are more prone to accidents and being unsteady, it is of upmost importance to ensure that their rehab program includes a mobility emphasis. Movement is important to prevent deconditioning, staying mobile, avoiding complications from hospital stays, and reducing your risk of falls.

“Your risk of falling increases as you age,” says Doctor Nataliya Dementovych. “So your goal, as age-friendly care providers, is to help you maintain mobility and body functions as long as you can.”

During a patient’s stay at a medical facility, early mobility is an important component to successful rehabilitation. In fact, early mobility is essential for preventing falls, delirium, and hospital-acquired deconditioning. Immobility can set off a cascade of negative outcomes, with one day in bed necessitating up to three weeks of recovery. Mobility programs need to incorporate safe patient-handling tools and structured mobility goals to promote patient independence.

Patient-centered care through mobility means prioritizing a patient’s individual needs and preferences regarding their movement abilities by actively encouraging and facilitating mobility as a key part of their healthcare plan. Patients must be involved in decision-making about their movement activities, while tailoring their interventions to maximize their independence and quality of life, while also respecting their limitations.

Because mobility is so important in the rehabilitation process, it is essential to actively incorporate a patient’s ability to move and function into the core of their healthcare plan. Be sure that all treatment decisions and interventions are designed to maintain or improve their mobility as much as possible. 

Key Aspects of Patient-Centered Care Through Mobility

Individual Assessment
Extensively evaluating a patient’s particular mobility needs, including functional limitations, discomfort levels, and goals for movement.

Patient Involvement
Actively and consistently engaging patients in discussions about their mobility goals and including them in selecting appropriate assistive devices and exercise routines.

Early Mobilization
Fostering movement as soon as it is safe to do so following an illness or surgery to prevent complications such as muscle atrophy and blood clots.

Multidisciplinary Approach
Collaborating with physical therapists, occupational therapists, nurses and other staff to develop a comprehensive mobility plan.

Respect for Patient Autonomy
Enabling patients to make their own choices about their mobility activities within safe limits, and that includes the level of assistance they need.

Managing Discomfort
Addressing discomfort effectively to facilitate movement and prevent more discomfort during mobility exercises.

Environmental Adaptation
Modifying the patient’s environment to foster mobility and safety. 

What Prioritizing Mobility in a Hospital Rehabilitation Program Looks Like 

A patient’s journey through rehabilitation is shaped by their unique medical history, functional goals, and the strategies employed by their care team. When mobility is prioritized from the outset, even individuals with complex conditions can achieve remarkable progress. The following case study illustrates how a structured, mobility-focused approach helped one patient regain independence after a critical health event.

A 65-year-old veteran was admitted to the ICU for a cardiac arrest and opioid overdose. With a history of kidney failure, PTSD, and falls, his frailty score was 5 (mild frailty). His goal was to regain independence.

Using the SECM (Safe Early Continuous Mobility) framework, the care team:

• Evaluated his prior level of function.
• Came up with a functional reconciliation plan.
• Addressed medication risks (for example, sedatives causing delirium).
• Included safe mobility interventions.
• Developed a discharge plan aligned with his medical goals.

Within just days, he progressed from ICU bed rest to walking with a walker, demonstrating how structured mobility interventions can improve rehabilitation outcomes. 

How Mobility-Centered Care Improves Patient Outcomes

Quicker Recovery
Contributes to a faster return to normal daily routines after illness or surgery.

Reduced Complications
Prevents issues such as pressure ulcers, deep vein thrombosis, and pneumonia that are associated with prolonged inactivity.

Improved Functional Independence
Allows patients to perform daily activities with more autonomy.

Enhanced Quality of Life
Fosters a sense of well-being and participation in desired activities.

Promoting mobility in a rehabilitative program is made easier with the use of proper equipment. Take for example the Barihab by Therapeutic Industries XS and XKS tables. Their advanced physical therapy treatment tables focus on delivering efficient and personalized care while providing the best in mobility treatment.

Conclusion

As the country’s population continues to age – with the “graying of America” – and more of our rehab hospitals seeing greater numbers of elderly patients, it is incumbent upon administrators to implement and document age-friendly practices in their rehabilitative programs.

Reporting on age-friendly practices at hospitals begins in 2026, with financial penalties for non-compliance.

Hospitals must also leverage existing mobility programs in order to meet 4Ms requirements. Safe Early Continuous Mobility (SECM) directly supports all four domains of age-friendly care.

By taking proactive steps now, you can create a culture of mobility, improve patient outcomes, and ensure compliance with CMS requirements at your rehabilitation hospital.