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Counting Patient Steps Predicts Readmissions Risk

By Alexandra Wilson Pecci  
   December 12, 2017

In a recent study, commercial activity monitors showed a correlation between the number of inpatient steps and the likelihood of readmission.

Research has linked physical activity with a lower risk of readmissions in medical conditions from COPD to heart failure.

Although every effort is made to get people moving while they're hospitalized, the intentions don't always match the outcomes. In a busy hospital, there are lots of other things competing for clinicians' attention and time.

"I think that people are just really busy," says Carissa Low, PhD, assistant professor of medicine and psychology in the Biobehavioral Oncology Program at the University of Pittsburgh Hillman Cancer Center.

"It's not usually the top priority," she adds. "It's easy for that to fall away."

It addition, physical activity isn't always easy to quantify or record in the EHR.

"It's not something that's tracked systematically," she says.

But electronic step counting might be able to change that.

Low is the lead author of a new study published in the Annals of Behavioral Medicine showing that patient activity during inpatient recovery predicted lower risk of 30- and 60-day readmission after surgery for metastatic peritoneal cancer.

Specifically, the researchers monitored patients using a Fitbit, and found that higher Fitbit step counts forecast better patient outcomes.

"Patients are encouraged to get up and walk as soon as possible after surgery," Low says, but doing so is often hard to keep up with and track.

The researchers wanted to know whether counting steps—which is easy and inexpensive to monitor and visualize—taken during inpatient recovery would predict 30- and 60-day readmission risk after metastatic cancer surgery.

Fitbits were placed on patients' wrists upon transfer from the ICU after surgery and worn for the duration of their inpatient stay. Researchers extracted information about hospital readmission from the patients' EHR. Researchers also helped to make sure the devices remained charged and were synced to the Fitbit server.

"The patients who took more steps during their stay were at lower risk for 30- and 60-day readmissions," Low said, even after statistically adjusting for age, body mass index, comorbidity, and length of postoperative stay.


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Alexandra Wilson Pecci is an editor for HealthLeaders.

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