This quick start guide aims to provide an easy way to introduce and begin implementing the Johns Hopkins Activity and Mobility Promotion (JH-AMP) 8-Step Framework and build a culture of mobility within your institution.
What is JH-AMP? | JH-AMP 8-Step Framework | Quick Start Guide
What is Johns Hopkins Activity and Mobility Promotion?
Hospitalized patients generally spend much of their day in bed. Whether patients are in the intensive care unit or in other hospital units, immobility and its associated negative consequences may increase the length of stay and hospital-acquired harms, leading to worse patient outcomes.
Similar to strategies employed to reduce hospital harms like falls and pressure injuries, a systematic approach for mobility is necessary to drive desired outcomes.
Johns Hopkins Activity and Mobility Promotion has established an eight-step framework that supports the development of a “culture of mobility” in hospitals.
JH-AMP 8-Step Framework
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Hospital leadership should establish JH-AMP as a priority to synergize with safety and quality initiatives (falls, pressure injuries and delirium) and strategic cost-reduction initiatives (length of stay, discharge planning and readmission reductions).
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Standardize measurement across clinical disciplines (nurses, physicians and rehabilitation therapists) to clearly identify changes in patient function and quantify success of mobility and activity promotion efforts. This common interprofessional metric set includes patient capacity (Activity Measure for Post-Acute Care (AM-PAC)), daily goal (Johns Hopkins Mobility Goal Calculator (JH-MGC)) and observed mobility performance (Johns Hopkins Highest Level of Mobility Scale (JH-HLM)).
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As with other quality improvement efforts, systematic barrier assessment is imperative. A cycle of process evaluation, barrier identification and solution-seeking should include (1) prioritized actions, (2) person(s) responsible, (3) action timelines and (4) additional stakeholders to be engaged.
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Facilitating hospitalized patient mobility to scale takes an interprofessional team. Explicit roles for nurses, rehabilitation therapists, physicians and other stakeholders are essential to align workflows, realize efficiencies and ensure accountability.
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Formal education and training are essential to implementation and sustainability efforts, as this helps promote consistency among clinicians. A tiered education strategy inclusive of onboarding, competency and just-in-time training will reinforce JH-AMP concepts.
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For effective implementation, JH-AMP needs to be incorporated into existing electronic and human workflows. The clinical team should communicate patient goals and performance as a care priority in rounds, huddles and handoffs, no different than fall risk, nutrition or concerning lab values.
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A critical component of implementing JH-AMP is to provide data feedback to stakeholders and front-line clinical staff members. The JH-AMP program includes three key performance indicators: (1) AM-PAC, (2) JH-HLM documentation compliance and (3) mobility goal achievement as determined by the JH-MGC.
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Promotion and awareness are critical components of sustaining effort in all quality improvement projects. JH-AMP includes promotion and messaging materials to bolster program visibility and prevent momentum loss.
Review our framework publication.
Our article, “The Johns Hopkins Activity and Mobility Promotion Program: A Framework to Increase Activity and Mobility Among Hospitalized Patients,” published in the Journal of Nursing Care Quality, provides program details and implementation methods for JH-AMP.
Download the Common Mobility Language Guide and Toolkit.
Systematic measurement is essential to drive any quality improvement process. Within this manual, you will find essential information to start using JH-AMP tools as you begin your journey to combating immobility harm and driving a successful mobility promotion campaign. #everyBODYmoves
Review other featured publications.
These publications describe our work on mobility-related hospital outcomes, measurement tool properties, barrier assessments, targeting rehabilitation, disposition prediction and systematic mobility promotion.
Take our foundations course.
This foundational course for hospital leaders and program implementers details the JH-AMP 8-step framework and explores the tools and resources needed to design and implement structured quality improvement processes.
View course program (.pdf).
Watch the sample video.Contact us at [email protected] to enroll in this course.
Explore additional education and implementation services.
John Hopkins Activity and Mobility Promotion offers a variety of education and consultation options, ranging from institution-level implementation support to hands-on front-line education. If you’re unsure of where to begin, contact us at [email protected].
Learn about our education and consultation offerings.
Learn about our annual conference.