Table 3.

Patient and Provider Perspectives on Factors that Influence Mobility

Themes	Quotes
PATIENTS
Intrapersonal
Patient Health Status	“Well I think they didn’t have me mobile because of my heart and my lungs. They’ve had me on monitors.”
Fear of falls	“But my leg been giving out on me because sometimes I can walk and sometimes I can’t. If I were walking it’d just give out. …it made me sit in a chair. I was scared.”
Losing autonomy	“When I’m getting ready to go to bed and I’ve got to go to the bathroom and then I got to pick up the phone and call and have somebody come to hold my hand when I go to the bathroom. …Yes, it’s irritating and plus the fact you won’t ever be able to say you can do it yourself if they keep taking it away from you and because they’re afraid they’re going to have somebody injured”.
Interpersonal
Communication	“Yes, they say I should you know walk around the nurse’s station or something like that, yes… they encourage me to, the doctor. It helps me. It helps me to get up and walk…The physical therapists, the nurses, the doctors; all of them.” “Well they haven’t talked to me too much about moving around since I been in here.”
Organizational
Moving safely	“I could walk more but they don’t want me to go by myself yet. Because they’re afraid I might fall.” “They were overly cautious but that’s because we’re in the hospital.”
PROVIDERS
Intrapersonal
Patient Health Status	“Some patients, you know, all that they could do prior to coming in was to get out of bed to a chair. Well that’s the benchmark, that’s what they need to do while they’re here in the hospital. For patients that are independent ambulators, they need to be independently ambulating.” [Hospitalist]
Interpersonal
Communication	“I think that has a lot to do with doctors a lot of times, just randomly ordering consults and not really looking at our assessment because you go like PT is coming to see them like for what? They’re walking around the hallways.” [Nurse] “We can make recommendations, but really we would have usually been consulted right when they first came in or if they were up mobilizing with nursing they might not have had that decline to begin with and we wouldn’t have been needed.” [PT and OT] “I think a lot of my fellow hospitalists will say the same thing. That’s the biggest thing they look for in PT notes is the discharge recommendation. So I don’t even know if they do put ambulation time in that PT note because it’s too long to go through.” [Hospitalist]
Organizational
Roles and Responsibility	“I think that there, in all honesty, is a general hesitation because we have such a high falls risk population that a lot of times especially maybe less experienced nurses will want to wait until there’s been a PT consult to kind of verify what’s the best way to move this person and that person may not even be on the agenda for a PT consult so then they sit in the bed these two or three days” [Nurse] “Physical therapy is used to doing this, that’s who should be doing this because I have other things to do besides try to figure out a plan of why somebody’s not being as mobile and stuff.” [Nurse] “We are lacking both human resources, physical resources, we may know that someone needs to use a walker, but we can’t get a walker unless PT brings it to the room”. [Nurse]
Environmental
Falls Never Event	“We still think that even the fall risk patients should get out of bed to a chair but I think even with that, when they get that falls risk thing put on we become less confident that we can encourage safe mobility. I think then, we tend to rely more on physical therapists” [Hospitalist]
Patient Geographic Location	“It’s just a culture commitment as buy in from like the nursing, the patients, the physicians, physical therapists that are on the unit and they have like, this goal towards mobility…they’re committed to it and it’s worked.” [Resident].