Design of a Mobile Application to Address Risk Factors for Hospital-Acquired Deconditioning and Delirium

Grant Application

Ben Smith, MD, University of Pittsburgh Department of Critical Care Medicine

Proposed Innovation

By 2030, every member of the baby boomer generation will be 65 or older, leading to a substantial increase in the number of older adults requiring hospitalization. Older patients are particularly vulnerable to hospital-acquired deconditioning (decline in physical function) and delirium (a state of confusion). Guidelines recommend that patients remain physically active to prevent these complications. However, many older patients are discouraged from mobilizing without assistance, which means they are not moving as much as they could be. These complications can extend hospital stays, increase the likelihood of needing post-acute care, and elevate mortality risks.

The proposal is for a mobile app designed to help patients and their family members address risk factors for delirium and deconditioning.

Improvements in Action

The proposed app would be provided by UPMC free of charge to all admitted patients and their loved ones to use on their personal mobile devices. The three core categories of intervention will be activity, guidance, and tools.

The activity category would offer guided videos with physical exercise designed for patients to perform unsupervised while in the bed or chair. Clinicians and rehabilitation experts would work to ensure each patient is assigned the appropriate level of activity for their safety and well-being. Guidance would provide step-by-step advice for navigating a hospital stay with helpful tips shown to help prevent delirium. The tools would help improve connectedness with family and friends and make use of simple interventions to improve sleep and provide stimulation.

Intended Outcomes

The overall goal of this project is improved patient outcomes, including a reduction in rates of delirium and deconditioning, a resultant decreased length of inpatient hospital stays, and a significant reduction in system health care costs. It is also anticipated to improve patient self-efficacy as well as patient and family experience by making them integral members of the care team.