Implementation of Systematic Testing of Basic Physical Function in Hospitalized Adults

Background Assessing physical function in hospitalized adult patients is considered important for early detection of functional decline, for improving patient outcomes, and enhancing healthcare quality. However, systematic assessment of physical function is rarely done, and if so, only in older patients. New strategies for systematic testing of physical function to detect signs of functional decline in all adult patients are therefore warranted. The aim was to implement three basic physical function tests across hospital departments and various diagnoses. Methods Implementation study describing deliverables, activities and survey data among 125 physio- and occupational therapists (PT and OT in 2022 and 2024, monthly audits of patient journals and rehabilitation plans, and number of tests performed, extracted from journal systems. Setting: Major acute university hospital. Three validated tests: the Cumulated Ambulation Score as a measure of basic mobility. The 30-seconds Sit-to-Stand Test and Handgrip strength. Results The number of tests performed improved by 36% from 2022 to 2024. The surveys demonstrated that skills and knowledge were well established. Still, PT and OT reported lack of meaningfulness in their clinical reasoning and failure to see the benefit for the patients regarding the implementation of the 3 tests. While some components were well accepted by staff, others require further development based on key questionnaire findings. Conclusion Overall, the first two years of implementation were successful with a marked increase of 36% in number of tests performed. The PT and OT were well-calibrated and actively engaged in testing, although challenge for the therapists to incorporate test results into clinical reasoning and goal setting together with the other findings.