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STRIDE

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STRIDE is a supervised walking program for older Veterans admitted to the hospital with medical illness. STRIDE features an early assessment, supervised ambulation, and patient education about the importance of daily walking, all designed to ensure patient safety during program participation. Developed with input from multiple disciplines, STRIDE fills an urgent need for promotion of early, safe mobility in hospitalized individuals to prevent negative consequences of inpatient bedrest and immobility.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.

Origin:

February 2012, Durham VA Medical Center

Adoptions:

52 successful, 17 in-progress

Awards and Recognition:

Diffusion of Excellence Promising Practice, VHA Shark Tank Winner, 2022 National Diffusion Award

Partners:

Diffusion of Excellence, Geriatrics and Extended Care, Office of Nursing Services, Quality Enhancement Research Initiative

Tags:

Age-Friendly Geriatric Health High Reliability Inpatient Care Nursing Veteran Experience
Contact Team

Overview

Problem

More than one-third of adults 70 and older are discharged from the hospital diagnosed with a new disability that was not present before the onset of acute illness. Loss of functional ability during hospitalization often arises as a result of immobility during the inpatient stay, contributing to loss of muscle mass and overall weakness, putting immobile patie ... See more

Images

Culture of immobility, negative physical effects, and adverse outcomes

Solution

STRIDE is a supervised walking program and aims to increase the amount of time spent safely out of bed and walking during inpatient hospital stays. The program features an early assessment, supervised ambulation, and patient education about the importance of daily walking, all designed to ensure patient safety during program participation.

Images

Consult, gait assessment, STRIDE

Results

Data from a demonstration trial at the Durham VA show that STRIDE participants were more likely to be discharged to their homes (92%) than STRIDE-eligible patients who did not enroll in the program (74%). Clinical data also show that STRIDE participants had a 1-day shorter length of hospitalization than STRIDE-eligible patients who did not enroll (4.7 days v ... See more

Images

from Hastings SN et al. J Am Geriatr Soc. 2014 Nov;62(11):2180-4.

STRIDE promising outcomes

Metrics

  • Discharge disposition
  • Length of stay
  • Distance/time walked
  • Adverse effects

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

AZ: Carl T. Hayden Veterans' Administration Medical Center (Phoenix, Arizona)
  • Started adoption on 10/2022.
AZ: Tucson VA Medical Center (Tucson)
  • Started adoption on 07/2021.
CA: Tibor Rubin VA Medical Center (Long Beach)
  • Started adoption on 07/2022.
CO: Aurora VA Clinic (Aurora, Colorado)
  • Started adoption on 10/2022.
CO: Grand Junction VA Medical Center (Grand Junction, Colorado)
  • Started adoption on 07/2022.
DE: Wilmington VA Medical Center (Wilmington, Delaware)
  • Started adoption on 11/2023.
FL: Bruce W. Carter Department of Veterans Affairs Medical Center (Miami)
  • Started adoption on 10/2022.
FL: James A. Haley Veterans' Hospital (Tampa, Florida)
  • Started adoption on 03/2019.
FL: Orlando VA Medical Center (Orlando)
  • Started adoption on 06/2020.
GA: Joseph Maxwell Cleland Atlanta VA Medical Center (Atlanta, Georgia)
  • Started adoption on 12/2017.
IA: Des Moines VA Medical Center (Des Moines, Iowa)
  • Started adoption on 04/2018.
IA: Iowa City VA Medical Center (Iowa City, Iowa) ID: Boise VA Medical Center (Boise)
  • Started adoption on 10/2022.
IL: Danville VA Medical Center (Danville, Illinois)
  • Started adoption on 03/2022.
IL: Marion VA Medical Center (Marion, Illinois)
  • Started adoption on 02/2023.
IN: Richard L. Roudebush Veterans' Administration Medical Center (Indianapolis, Indiana)
  • Started adoption on 10/2021.
KY: Robley Rex Department of Veterans Affairs Medical Center (Louisville)
  • Started adoption on 02/2018.
MA: West Roxbury VA Medical Center (West Roxbury)
  • Started adoption on 10/2022.
MI: John D. Dingell Department of Veterans Affairs Medical Center (Detroit)
  • Started adoption on 03/2022.
MI: Oscar G. Johnson Department of Veterans Affairs Medical Facility (Iron Mountain)
  • Started adoption on 10/2022.
MN: Minneapolis VA Medical Center (Minneapolis, Minnesota)
  • Started adoption on 04/2018.
MN: St. Cloud VA Medical Center (St. Cloud) MO: John J. Cochran Veterans Hospital (St. Louis John Cochran)
  • Started adoption on 10/2022.
MT: Fort Harrison VA Medical Center (Fort Harrison)
  • Started adoption on 06/2023.
NC: Charles George Department of Veterans Affairs Medical Center (Asheville)
  • Started adoption on 01/2017.
NC: Durham VA Medical Center (Durham) NC: Fayetteville VA Medical Center (Fayetteville, North Carolina)
  • Started adoption on 01/2017.
NJ: East Orange VA Medical Center (East Orange)
  • Started adoption on 10/2022.
NV: Ioannis A. Lougaris Veterans' Administration Medical Center (Reno)
  • Started adoption on 10/2022.
NV: North Las Vegas VA Medical Center (North Las Vegas)
  • Started adoption on 07/2022.
NY: Bath VA Medical Center (Bath)
  • Started adoption on 03/2024.
NY: Buffalo VA Medical Center (Buffalo, New York)
  • Started adoption on 10/2022.
NY: Canandaigua VA Medical Center (Canandaigua)
  • Started adoption on 02/2024.
NY: Castle Point VA Medical Center (Castle Point)
  • Started adoption on 06/2023.
NY: Syracuse VA Medical Center (Syracuse)
  • Started adoption on 07/2022.
OH: Cincinnati VA Medical Center (Cincinnati, Ohio)
  • Started adoption on 04/2019.
OH: Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio)
  • Started adoption on 12/2023.
OR: Portland VA Medical Center (Portland, Oregon)
  • Started adoption on 10/2022.
PR: San Juan VA Medical Center (San Juan)
  • Started adoption on 07/2022.
SC: Ralph H. Johnson Department of Veterans Affairs Medical Center (Charleston, South Carolina)
  • Started adoption on 03/2022.
SC: Wm. Jennings Bryan Dorn Department of Veterans Affairs Medical Center (Columbia, South Carolina)
  • Started adoption on 04/2019.
SD: Royal C. Johnson Veterans' Memorial Hospital (Sioux Falls)
  • Started adoption on 07/2021.
TN: James H. Quillen Department of Veterans Affairs Medical Center (Mountain Home, Tennessee)
  • Started adoption on 10/2021.
TN: Lt. Col. Luke Weathers, Jr. VA Medical Center (Memphis)
  • Started adoption on 10/2021.
TN: Nashville VA Medical Center (Nashville)
  • Started adoption on 10/2021.
UT: George E. Wahlen Department of Veterans Affairs Medical Center (Salt Lake City)
  • Started adoption on 06/2021.
VA: Hampton VA Medical Center (Hampton)
  • Started adoption on 01/2017.
VT: White River Junction VA Medical Center (White River Junction)
  • Started adoption on 07/2022.
WI: Clement J. Zablocki Veterans' Administration Medical Center (Milwaukee, Wisconsin)
  • Started adoption on 10/2020.
WI: Tomah VA Medical Center (Tomah)
  • Started adoption on 07/2022.
WI: William S. Middleton Memorial Veterans' Hospital (Madison)
  • Started adoption on 07/2022.
WV: Martinsburg VA Medical Center (Martinsburg)
  • Started adoption on 04/2019.

AR: Fayetteville VA Medical Center (Fayetteville, Arkansas)
  • Started adoption on 10/2022.
CA: West Los Angeles VA Medical Center (West Los Angeles)
  • Started adoption on 06/2023.
FL: C.W. Bill Young Department of Veterans Affairs Medical Center (Bay Pines)
  • Started adoption on 11/2023.
IL: Edward Hines Junior Hospital (Hines)
  • Started adoption on 01/2019.
IL: Jesse Brown Department of Veterans Affairs Medical Center (Chicago, Illinois)
  • Started adoption on 04/2023.
KS: Robert J. Dole Department of Veterans Affairs Medical and Regional Office Center (Wichita)
  • Started adoption on 10/2021.
KY: Franklin R. Sousley Campus (Lexington Leestown)
  • Started adoption on 10/2021.
MD: Baltimore VA Medical Center (Baltimore) ND: Fargo VA Medical Center (Fargo)
  • Started adoption on 09/2021.
NE: Omaha VA Medical Center (Omaha, Nebraska) NY: James J. Peters Department of Veterans Affairs Medical Center (Bronx)
  • Started adoption on 09/2023.
NY: Northport VA Medical Center (Northport)
  • Started adoption on 10/2022.
PA: Corporal Michael J. Crescenz Department of Veterans Affairs Medical Center (Philadelphia, Pennsylvania)
  • Started adoption on 01/2019.
SD: Hot Springs VA Medical Center (Hot Springs, South Dakota) TX: Michael E. DeBakey Department of Veterans Affairs Medical Center (Houston)
  • Started adoption on 03/2019.
VA: Salem VA Medical Center (Salem, Virginia)
  • Started adoption on 01/2017.
WA: Seattle VA Medical Center (Seattle)
  • Started adoption on 10/2021.

There are no unsuccessful adoptions for this innovation.

Multimedia

Images

Veteran walking with STRIDE

Videos

STRIDE video from Durham VA

Implementation

Timeline

  • 3-4 months before program launch
    Planning phase: designate STRIDE team, tailor documentation templates for local needs, decide on process metrics to track, create marketing and education plan, test that data is populating the VSSC workload reports
  • Program launch
    Enroll patients in STRIDE on a pilot ward
  • 1 month post-launch
    Review and evaluate program data

Departments

  • Extended care and rehabilitation
  • Geriatrics
  • Hospital medicine
  • Nursing services
  • Physical medicine and rehabilitation
  • Physical therapy, occupational therapy and kinesiothology

Core Resources

Resource type Resource description
PEOPLE
  • Physical Therapist (or other evaluating staff member), either dedicated to STRIDE or in conjunction with other duties
  • Mobility Assistant (e.g. CNA, HCT, PTA, RTA), either dedicated to STRIDE or in conjunction with other duties
  • Clinical Applications Coordinator required to upload STRIDE CPRS templates (one time upload))
TOOLS
  • Vitals equipment (e.g. BP cuff, pulse oximeter)
  • Laptop or computer station to record assessment and walk data

Optional Resources

Resource type Resource description
PROCESSES
  • Patient education and marketing materials
TOOLS
  • Walking devices (e.g. gait belts, walkers, canes)
  • Stop watch, timer, measurement wheel

Support Resources

Resource type Resource description
TOOLS
  • STRIDE Toolkit

Risks and mitigations

Risk Mitigation
Role clarity among clinical STRIDE team Designate key staff as champions, regularly educate new staff, and meet regularly to review workload and process metrics
Falls Mobility assistants are trained specifically to supervise STRIDE walks using a competency checklist, which addresses falls safety and indicators of patient distress or weakness.

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

Email

Email with questions about this innovation.

About

Origin story

To combat the issue of prolonged, unnecessary bedrest in the inpatient setting, Dr. Hastings developed the STRIDE program, a supervised walking program for hospitalized older adults. In 2012, this program was further developed by an interdisciplinary team of research physicians and piloted at the Durham VA Health Care System.

Original team

Susan N. Hastings

Director, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT)

Caitlin Kappler

STRIDE Project Coordinator

Ashley Choate

STRIDE Implementation Specialist

Amy Webster

STRIDE Research Assistant

Carl McCoy

Diffusion Specialist, VHA Diffusion of Excellence

Search tags

Age-Friendly Geriatric Health High Reliability Inpatient Care Nursing Veteran Experience